Ch. 13: Neurocognitive disorders Flashcards
Neurocognitive disorders intro
These are disorders in which a clinically significant deficit in cognition or memory exists, representing a significant change from a previous level of functioning.
Delirium
- Characterized by a disturbance in level of awareness and a change in cognition. Develops rapidly over a short period (hours or days).
- up to 80% of ICU patients, 83% end of life patients.
- Acute change. Shouldn’t be in psych ward. common after being on a ventilator.
Delirium and medical issues
- Can have an underlying systemic illness. Duration is usually brief and subsides completely on recovery from underlying cause.
- UTIs, BPH –> kidney damage –> delirium
Predisposing factors for delirium
- People over the age of 50 are at higher risk for this. Mostly due to risk of chronic disease.
- Infections, febrile illnesses, head trauma, seizures.
Substance induced delirium
- Can be prescribed meds like anticholinergics or even steroids. People all react differently to meds.
- Lots of S/E with prednisone
- Toxins, alcohol, cannabinoids, cocaine, others.
- Lead, mercury, carbon monoxide, etc.
Tx suggestions
- Minimize some senses
- Lights and noise down…maybe use earplugs?
- Less lines is better
- Bring in comforting pics
- If using haloperidol in elderly, use really small amount.
- Room near nurse’s station
Mild & Major NCD
- Minor neurocognitive impairment has also been called mild cognitive impairment. Like brain fog during + after covid.
- Major NCD constitutes what was previously called dementia.
Primary NCDs
…are those in which the disorder itself is the major sign of some organic brain disease not directly related to any other organic illness (e.g. Alzheimers)
Secondary NCDs
…are caused by or related to another disease of condition (e.g. HIV disease or cerebral trauma)
Symptoms of NCDs
- Can totally change what a person would normally do.
- Impairment exists in abstract thinking, judgment, and impulse control.
- Some may revert to their 1st language.
- Aphasia can lead to not being able to talk anymore. They know what they wanna say but they can’t say it.
Reversible NCDs (temporary dementia) can result from
- stroke, depression, side effects of meds, nutritional deficiencies, CNS infections, metabolic disorders.
- May see pseudo-dementia in people with depression.
- B12 deficiency can cause psych illness that can be treated.
Most NCDs are reversible and follow a progressive course. These symptoms may include…
- Aphasia
- Apraxia –> Motor function impairment
- Inability to care for personal needs
- Wandering
- Incontinence
- Agnosia: inability to interpret things. What should I do with this pen?
NCD: Alzheimer’s disease
- 50 - 80% of all NCD cases
- Described in 7 stages
I literally am too tired to finish this flashcard set sorry!
RIP
