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Flashcards in Cognitive Disorders Deck (26):
1

assessment guidelines for delirium

determine fluctuating LOC and risk for injury
ask family for baseline LOC and cognition
determine whether or not underlying cause
assess VS and neuro status for comfort care

2

4 cardinal features of delirium

acute onset/fluctuating course
inattention
disorganized thinking
altered LOC

3

nurs dx for delirium

acute confusion
risk for injury
disturbed thought process
fear
self-care deficit
impaired verbal communication

4

s/s of delirium

agitation, confusion, sun downing (night time exacerbation of symptoms)
Hallucinations
Increased HR

5

mgmt. of delirium

speak in simple concrete phrases
comprehensive nurse assessment
use reality orientation (clocks, calendars, family pics)
have pt. wear glasses/hearing aids
utilize same staff whenever possible

6

communication guidelines for delirium

always identify yourself
use short, simple words
focus on one thing at a time
talk about familiar things
focus on reality when pt. is delusional

7

short term outcomes of delirium are r/t

ongoing change in condition (VS, skin turgor, urine-specific gravity)

8

long term outcomes of delirium are r/t

individual safety, AAOx3, underlying cause identified/treated

9

what is dementia

impaired cognitive function, slowly deteriorating social and occupational functioning, levels of alertness are generally not disturbed.

10

what are the stages of Alzheimer's

Stage 1 - mild - forgetfulness
Stage 2 - moderate - confusion
Stage 3 - moderate to severe - unable to identify objects/people
Stage 4 - late - end-stage

11

how many stages of Alzheimer's

4

12

early signs of Alzheimer's

memory loss effecting job skills
diff. performing usual tasks
problems w/language
disoriented to time and place
poor or decreased judgment
problems thinking abstractly
misplacing things (keys)
changes in mood/behavior/personality
loss of initiative

13

signs of Alzheimer's progression

Dysphasia
Apraxia
Visual agnosia
Dysgraphia
Some long-term memory loss
Wandering

14

signs of late stage Alzheimer's

long-term memory loss
unable to communicate
cannot perform ADL's
require total care (incontinence)

15

dx of Alzheimer's

health hx, physical exam, neuro assess, mental assess, lab tests
CT, MRI, SPECT, PET
monitor early stages/trt. response

16

nurse dx r/t Alzheimer's

chronic confusion
risk for injury
impaired verbal communication/memory
care-giver role strain

17

targeted areas of trt. for Alzheimer's

Injury
Communication
Agitation level
Caregiver role strain
Self-care needs

18

communication guidelines for Alzheimer's

identify yourself
call the person by their name
speak slowly using short, simple words/phrases
use face-to-face contact
focus on 1 thing at a time
talk about familiar things
encourage reminiscing about happy times
with delusions reinforce reality, acknowledge pt. feelings
be close to the person when talking
have the pt. wear glasses/hearing aids

19

with an Alzheimer's pt. never do this

rush/hurry
criticize/correct/argue
talk as though the person isn't present
take challenging behaviors personally
use condescending terms

20

mgmt. of Alzheimer's is aimed at

improve/control decline in cognition
control undesirable behaviors (may be aggressive or angry)
provide care for the caregiver
community supports
pharmacology

21

when creating a SAFE environment for Alzheimer's consider this

gradually restrict driving
remove rugs
min. sensory stimulation
give support/chg. topic when verbally upset
label things
install safety bars
supervise smoking

22

mgmt. of wandering r/t Alzheimer's

place mattress on floor or use bed monitor
medic-alert bracelet and ID
notify police, tell neighbors
install complex locks
explore GPS devices

23

engaging activities for Alzheimer patients

picture magazines/children's books when reading is compromised
familiar/simple group activities
physical activity during the day

24

objective data r/t Alzheimer

disheveled appearance
early, late, middle neuro

25

subjective data r/t a;Alzheimer

past health hx
meds
nutrition info
elimination info
sleep-rest pattern

26

What is the last thing to change in alzheimers

Thought, long term memory in tact, short term memory is the problem