- 20% is used for brain functioning

Act directly on CNS - Side effect - Toxicty

- Head Trauma - Degenerative Process - Infectious Process

Cognitive Process Flashcards by Emily Pettis

Is the systemic ways a person, thinks, reasons, and uses language
-Requires conscious thought, memory, learning, and language

Cognition

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Cognition is coordinated by what part of brain?

Cerbral Cortex

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What three things are required for perception to occur?

A functioning sensory system
Neurotransmission
Processing

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What are the three types of sensory receptors?

Enteroceptors
Propioceptors
Interoceptors

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EXTERNAL
Vision, hearing, pain, and somatic receptors.
Anything that responds to stimuli from external environment

Exteroceptors

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POSITION
Inner ear, muscles, tendons, and joints.
Relates to body’s physical state, position and sensation of movement.

Proprioceptors

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INTERNAL
Viscera and deep tissues
Relates to change in internal environment

Interoreceptors

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Nursing and Cognitive FXN

Consciousness
Orientation
Judgement
Memory 
Comprehension
Language

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Newborn Infant

Sensorimotor

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Toddler-Preschool

Object permanence
Verbal language and reasoning develop
Egocentric view
Concrete thinking

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School age- Adolescent

School-age develops abstract thinking

Adolescents begin to perform complex mental processes

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Adult-Older Adult

Rational thinking
Increased age=higher likelihood of neurological impairments.
Cognitive impairments are not considered a “normal” sign of aging.

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Factors affecting cognitive function

Oxygenation/Circulation
Nutrition
Fluid and Electrolyte Balance
Medications
Medical
Environment

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Oxygen

20% is used for brain functioning

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Nutrition

-25% of glucose is used by the brain

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Iron

is needed for hemoglobin

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F&E

Which electrolyte has the biggest influence on water?

Metabolic by-products

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Medication

Act directly on CNS

Side effect
Toxicty

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Medical

Head Trauma
Degenerative Process
Infectious Process

Environment

Multiple Factors

Delirium

Acute change in mentation, consciousness, or the ability to maintain attention.

Delirium increases what

Increases mortality risk, hospital length of stay, long term cognitive impairment

Hyperactive

Easiest to assess. Disruptive

Hypoactive

Most common. underdiagnosed. higher risk of mortality. often labled ad “sleepy/quiet/sedated/withdrawn/

Mixed

Presence of both wax and wane

Risk Factors of Delirium

- Meds, Anesthesia, ICU on ventilator, Stroke, Dementia, Resp failure, spesis, drug abuse, alcohol abuse, isolation

Nursing Management of Delirium

- Pt's cognitive baseline - Confusion Assessment Method (CAM) - Early ambulation - Limit restraint use - Promote adequate sleep - Frequent Isolation - Enhance Sensory Stimuli

Dementia

Progressive impairment of intellectual function and memory. Gradual Decline Permanent

Alzheimer Dementia

Cerebral atrophy or shrinking of cortex

Vascular Dementia

Inadequate blood flow due to plaques or arterial brain lesions

Frontotemporal Dementia

Nerve cell loss and impairment of frontal and anterior temporal lobes

Lewy Body DEmentia

Clumps of protein causing neurodegeneration

Parkinson's Disease Dementia

If dementia occurs greater than 1 yr after Parkinson’s

Depression

Treatable Disease | Consider experiences that the aging person may experience

Symptoms of depression in elderly

Forgetfulness Fatigue Changes in behavior or mood

Dysarthria

Impaired speech related to motor control, weakness, paralysis, or incoordination of the oral musculature Hearing not impacted Can write or select words appropriately

Aphasia

- Complete or partial loss of language abilities. - Expressive Aphasia - Anomia - Receptive Aphasia - Global Aphasia

Expressive aphasia

Oral: nonfluent, telegraphic Written: Limited Comprehension: usually good

Receptive

Oral: FLuent, speech is well-articulated, disorganized content Written: Impaired Comprehension: Impaired

Anomic

ORal: Speech fluent, talks around the subject Written: Variable, mild- severe impairment Comprehension: VAriable, mild-severe impairment

GLobal

ORal: speech very poor, meaningless recurrent sounds Written: Severely impaired Comprehension: Severely impaired

What can the nurse use to assess alterations in cognitive function

``` Mini-Mental Status Exam or Pfeiffer - Pfeiffer (Box 39-3) 10 questions A correct response gets a 1 Score of 7 or less indicates cognitive impairment ```

Family suppport

Educate family members Observe for signs of caregiver burnout Observe for signs of elder abuse

Day and Respite care

Measure to help relieve family members of caregiver role strain

Socialization therapies

Social groups Hobbies Promotes pleasant memories

LTC

- Support caregivers in the decision to move a family member to a facility - Can provide a consistent structured environment with others for interaction