Alzheimer Disease

Question 1

What is Alzheimer’s disease?

Answer 1

Chronic progressive irreducible neurodegenerative brain disease

Question 2

Alzheimer’s is __ to __ of all dementias

Answer 2

60-80%

Question 3

Alzheimer’s is a progressive diseases which means it has 3 levels?

Answer 3

Mild
Moderate
Severe

Question 4

Alzheimer disease is also known a as the ??

Answer 4

Long goodbye or death in slow motion

Question 5

Most common in gender?
And has a late ??

What are biological factors?(2)

Risk factors
- age and family
- cardiovascular disease
- social engagement and diet
- head injury & tramua brain I just

Answer 5

Female
Onset

Neuronal degeneration
Genetics

Question 6

It’s important to know that the brain and heart/circulatory health are closely linked
So many factors that increase the risk of cardiovascular disease
- name them (5)

Will increase the risk of Alzheimer’s disease

Answer 6

Diabetes
Hypertension
Obesity
Hypercholesterolemia ( high cholesterol )
Smoking

Question 7

Diabetes has a significant increase risk of developing Alzheimer’s disease or any form of disease why? (2)

Answer 7

Because of
Chronic high levels of insulin and glucose may be toxic to the brain

Insulin resistance may interfere with ability to break down amyloid

( amyloid, a protein that forms brain plague in AD )

Question 8

Another huge risk for developing AD is head trauma why?
Don’t over think it

Answer 8

Because anything hitting the head will cause huge damage

Question 9

Application of nursing processs
Assessment
Defense mechanism of a AD patients is? (4)

Answer 9

Denial

Confabulation
( creation of stores in place of missing Memories to maintain self esteem )

Perseveration
( repetition of phrases or behavior )

Avoidance of questions

Question 10

What are the 5 main symptoms of AD?

Answer 10

Memory impairment
Disturbances in executive functioning
Aphasia ( loss of language ability )
Apraxia ( loss of coordination )
Agnosia ( loss of sensory ability to recognized objects )

Question 11

What are the 10 early warning signs of AD?

Answer 11

1. Memory loss that effects job skills
2. Difficulty performing familiar tasks
3. Problems with language
4. Disorientation to time & place
5. Poor judgment
6. Problems with abstract thinking
7. Misplacing things
8. Change in mood/behavior
9. Change in personality
10. Loss of initiative

Question 12

Does normal memory decline interfere with ADLS?

Answer 12

No!!

Question 13

What does recent memory loss mean?
What does remote memory loss mean?

These two recent and remote memory loss ; will they interfere with a patients ADLS? And this will ultimately lead to the patient being unable to?

Answer 13

Early
Lost as disease progresses

Yes ; take care of themselves

Question 14

As alzheimer disease progression
The patients personal hygiene and concentration and attention will ??

They will have unpredictable behavior and hallucinations; in which the patient has what??

Answer 14

Decrease

No control over

Question 15

Alzheimer patients will under reterogenesis, what does that mean?

Answer 15

Process where degenerative changes occur in reverse order in which they were required

( they start turning into a kid again, from speaking like an adult, to not even being able to hold up there head like an newborn )

Question 16

What is the second stage in the spectrum of AD?

Answer 16

Mild cognitive impairment

Question 17

What is mild cognitive impairment?

Are these problems severe to be noticed by others?

Can it show up on tests??

Does this help meet the criteria for dementia?

Answer 17

Cognitive function in which persons have problems with memory, language, or other cognitive functions

Yea

Yes

No

Question 18

Acute care
Diagnosis is very traumatic for patients, so it’s important that the nurse assess the patients for?

Not only is the patient at risk, but we also want to help out family caregivers because they could be in?

Patients will often respond with
- depression
- denial
- anxiety
- withdrawal
- feelings of loss

Answer 18

Depression or suicidal ideation

Denial or delaying critical care

Question 19

Acute care
It’s important to work and collaboration with the patients caregiver in order to?

Answer 19

Help manage clinical manifestations and engagement with client and caregiver

Question 20

It’s important to note that patients with AD are subject to hospitalizations for other problems!!

It’s important that the care giver and nurse focus there attention on the patient to____otherwise it’s there responsibility

It’s also not that fun for ad patients to be hospitalized since it increases ?(2)

Answer 20

Communicate!!

Delirium & dementia

Question 21

Ambulatory care
It’s important to know that AD is a progressive disease and will get worse over time so it’s important for care givers and friends to ?? (2)
Don’t over think it

Answer 21

Choose a right location & care giver

Question 22

Ambulatory care for Alzheimer’s disease
In early stages it’s important to use memory aids ; what is it and why?

We can also developers depression
, in which advance directives should be set why?

Answer 22

Memory aids is like a calendar
To help Tract and report status of a patient

Because it has a massive impact on a patient ADLS

Question 23

Not only can we use family care and calendars, we have adult care, which can help as patients how?

Answer 23

Live
ADLS
safety
Stimulation

Question 24

Just remmeber, as a patient with alzheimer reaches a full on patient needed care, you as a nurse are responsible for?

Answer 24

Safety!!!!!!!! And performing ADLS

Question 25

Behavior problems in AD patients are? (9)

Answer 25

Repetitiveness Delusions Hallucinations Agitation Aggression Altered sleep patterns Wandering Hoarding Resisting care

Question 26

Problems as mentioned before can be ____ and ____ ? Which often leads patients to go to? Remember, patients aren’t doing this on purpose and are difficult to control

Answer 26

unpredictable and challenging Institutional care settings

Question 27

What are the ways we see a patient respond to the problems mentioned before ? (4)

Answer 27

Pain Frustration Temperature extremes Anxiety

Question 28

When an AD patient is experience those problems and performing those behaviors It’s important that we as nurses will make a plan to protect the patient But we also want to assess (2) Maybe we might want to remove any triggers and reassure the patient that it’s safe However, patients also can’t speak sometimes, so what’s the most important thing to look out for? You should never ask a patient what thing?

Answer 28

Vital signs Environment There mood!! The way they responded to problems Why!!

Question 29

What are diagnostic test we can do for AD? (6)

Answer 29

CT PET mini mental stat examination Physical/neuro exam Medical history Medications/nutrition/symptoms

Question 30

Notes Nursing process Family assessment - realistic understanding of the disease - stress mangamenr - support & educate - realistic outcomes - maintain good self care

Question 31

Alzheimer disease disrupts all aspects of a person life It is very stressful for the patient and the caregivers So it’s important to note that we as nurses should also watch out for caregivers because?

Answer 31

It can lead to conflict and Strain Not to mention, loss of employment and a toll on emotional and physical health

Question 32

Did you know that caregiving increases the risk for development of dementia?? How does this work?

Answer 32

Chronic and severe stress can effect the hippocampus ( this is a place where it’s responsible for memory )

Question 33

Notes Outcomes identification Planning - connect caregivers to support services Intervention - person centered care approach - health teaching and health promotion - referral to community supports - pharmacological intervention - integrative therapy Evaluation

Question 34

Alzheimer disease Safety risk for injury / wandering We want to ? (3)

Answer 34

Minimize risk in home environment - implement all possible safety strategies Supervision Wandering is a major concern - observe factors or events - medical alert + safe return - GPS

Question 35

Alzheimer disease Pain management Impaired communication Pain should be recognized and treated promptly But how? (3)

Answer 35

Monitor patient response Patient difficulty communicating complaints May exhibit change in behavior

Question 36

Alzheimer disease Eating and swallowing difficulties We want to? (2) What are two short term possibilities But we want to be careful because of?

Answer 36

Offer liquids Finger foods which allow self feeding NG PEG tubes Aspiration

Question 37

Undernutrition is a problem in modereate and severe stages of Alzheimer’s Because patients loose internet in foods and that decreases their ability to self feed ( apraxia ) So it’s important to have foods like? To encourage eating What type of environment do we want for these patients when eating ? We also want what type of utensils?

Answer 37

Puréed, thicken liquids and nutritional supplements Quiet and unhurried Easy grip

Question 38

In late stages of Alzheimer disease, it’s important to always assess a patient oral care because when they stop having those functions, it can lead to?

Answer 38

Tooth decay and dental problems !

Question 39

What are two most common infections AD patients get? And any signs of these two manifestations need prompt evaluation and treatment !

Answer 39

UTI and pneumonia ( most common death )

Question 40

In late stages of AD, patients are unable to take care of there skin, and that leads to skin breakdown. We often see ? So it’s important to keep the skin __ and __ And to avoid skin breakdown we want to do what with the patient?

Answer 40

Rashes and redness Dry and clean Change position regularly

Question 41

Urinary and fecal Incontience during middle to late stages will lead the patient to get what?

Answer 41

UTI

Question 42

Constipation may relate to immobility and dietary intake So it’s important to increase patients what?

Answer 42

Fluids !!

Question 43

What are the expected outcomes of AD? (4)

Answer 43

Functions at the highest ADLS! No injuries Remains in a restricted area ( no wandering )