Dementia 3 Flashcards
91 y/o hospice pt w/ cachexia, end stage dementia, and renal impairment has stopped eating and drinking.
What comfort measure would be most appropriate?
Frequent small sips of water
Psych eval of 82 y/o F w/ memory loss (mostly working memory).
She frequently calls for help w/ bathroom, but will urinate on herself (staff feel she is doing this to get back at them). Pt frustrated w/ staff because she has sudden urged to void w/o much warning and wishes staff would arrive sooner and she is embarrassed.
MSE significant for moderate memory loss. Labs wnl.
Which behavioral intervention should be attempted?
Schedule regular voiding, independent of pt’s requests. Frequent enough to eliminate accidents
Which is important when working w/ family members who are caregivers to pts w/ dementia?
A. There needs to be only 1 caregiver at a time
B. Grief work w/ family not necessary before pt dies
C. All family to equally share caregiving responsibilities
D. Work with family should enhance effectiveness of care to pt
E. Family should explore skilled nursing facility options as soon as pt is dx
Work with family should enhance effectiveness of care to pt
Executive abilities in healthy pts > 65 y/o show
No significant changes
Speech is fluent w/ preserved comprehension. However, unable to repeat statements.
Consistent with what type of aphasia?
Conduction
In normal aging the last cognitive ability to decline is
Word knowledge
Medicare pays for hospice when a physician states that a pt has a maximum life expectancy of?
6 months
2 days after bowel surgery, 53 y/o pt is delirious. Correctly draws a square when asked. But then continues to draw squares when asked to draw other shapes. MSE reveals
Perseveration
Cancer pt on chemo is disoriented and agitated. Afebrile VS. Neg neuro exam.
Poor attention, cog impairment.
CT - neg. EEG - diffuse slowing.
Treat with?
Haldol
78 y/o pt with alzheimers living w/ spouse and daughter. Starting to accuse spouse of infidelity. On eval, asserts spouse is unfaithful. He is alert and acts congenially w/ the spouse. He is on donepezil. Labs and medical work up is unrevealing of any disorder outside of dementia. Next?
Arrange for regular evals of pt and reassure family
Family of 75 y/o is concerned about his safety b/c he has been forgetting to turn off stove. MD suspects evolving cognitive DO. What is most likely to be earliest impairment to occur?
Inability to recall 3 words after 3 min delay
85 y/o nursing home pt w/ hx of dementia being more confused and screaming “fire” whenever light next to the bed is turned on.
Next step?
UA
