Exam 2 - mental health & dementia

Question 1

what are the physiological changes in the brain of older adults?

Answer 1

• neuron loss
• brain atrophy
• dendrites atrophy

everything is lost or shrinking

Question 2

where is neuron loss more pronounced?

Answer 2

cerebral cortex

Question 3

what are the neurotransmitters that have a big impact on older adults?

Answer 3

• acetylcholine
• serotonin
• dopamine

Question 4

why do nurses need a complete assessment (including lab work) with an older adult that exhibits MCI?

Answer 4

to rule out any causes of cognitive impairment

Question 5

any form of mental health disorders is not normal

Answer 5

true

Question 6

common mental disorders in late life

Answer 6

• depression
• anxiety
• mood disorders
• alcohol abuse
• alcohol dependence

Question 7

what type of questions does a nurse ask when conducting a mental health assessment on an older adult?

Answer 7

• history of their ability to cope with stress
• availability of social support
• loss of loved ones

Question 8

what are the components of an evaluation of an older adult’s mental health?

Answer 8

• cognitive function
• substance abuse
• suicide risk

Question 9

what are interventions for older adults with mental illness?

Answer 9

• enhance resilience & resourcefulness
• enhance functional status & independence
• promote sense of control
• foster social supports & relationships
• educate about available resources

Question 10

life events & stressors have a strong correlation to development of anxiety disorders

Answer 10

true

Question 11

what situations is anxiety associated with?

Answer 11

• excessive healthcare use
• decreased physical activity & functional status
• substance abuse
• decreased life satisfaction
• increased mortality rates

Question 12

anxiety is a common side effect for many drugs that older adults use

Answer 12

true

Question 13

anxiety is hard to diagnose in older adults due to their denial

Answer 13

true

Question 14

it is possible that coexisting medical conditions & certain medications can mimic anxiety & depression

Answer 14

true

Question 15

pharmacological interventions for anxiety

Answer 15

• SSRIs
• short-acting benzodiazepines
• non-benzodiazepine anxiolytic agents

Question 16

non-pharmacological interventions for anxiety

Answer 16

• CBT
• meditation
• yoga

Question 17

how does depression present in older adults?

Answer 17

• low libido
• somatic complaints
• decreased energy
• social withdrawal
• preoccupation with death
• memory problems
• hypochondriasis

Question 18

what is the most common mental illness among the older population?

Answer 18

depression

Question 19

what are the assessment tools that nurses use for depression in older adults?

Answer 19

• Depression Screening Scale
• laboratory analysis
• medication review
• Geriatric Depression Scale
• functional assessment
• cognitive assessment

Question 20

why do men have higher suicide rates than women?

Answer 20

they have the means to carry out their suicidal intentions

Question 21

which population is most vulnerable to suicide?

Answer 21

old widowers

Question 22

what are the questions to ask to assess suicide risk?

Answer 22

• Have you thought about killing yourself?
• How often do you have these thoughts?
• Do you have a plan to carry it out?

direct questions

Question 23

where is substance detoxification best implemented?

Answer 23

inpatient setting

Question 24

what is the assessment tool for delirium?

Answer 24

Confusion Assessment Method

Question 25

what are the interventions for delirium?

Answer 25

- sensory enhancement - ambulate twice a day - nutritional & fluid enhancement - pain management

Question 26

what are the syndromes of dementia?

Answer 26

- aphasia - apraxia - agnosia - disturbances in executive functioning

Question 27

example of a non-benzodiazepine anxiolytic agent

Answer 27

Buspar

Question 28

which type of drug is the ***last resort*** in treating anxiety?

Answer 28

benzodiazepine

Question 29

what is the ***last resort*** in treating depression?

Answer 29

ECT

Question 30

which population is more likely to abuse alcohol?

Answer 30

White men

Question 31

what are the two types of Alzheimer's disease?

Answer 31

- early onset - late onset

Question 32

characteristics of *early onset AD*

Answer 32

- starts around 30-60 years old - genetic mutation of 3 genes

Question 33

what are the stages of Alzheimer's Disease?

Answer 33

- Preclinical - Mild Cognitive Impairment - Final Stage

Question 33

characteristics of *late onset AD*

Answer 33

- starts at 60 years old - combination of lifestyle, environmental factors, & genetic mutation

Question 34

characteristics of preclinical stage (AD)

Answer 34

- lumbar puncture is indicated - early cognitive decline (onset 5-20 years prior to obvious manifestations)

Question 35

characteristics of *mild cognitive impairment* stage

Answer 35

- amnesiac - no sense of personal space - needs full-time assistance - communication impaired - risk for pneumonia

Question 36

characteristic of *final* stage

Answer 36

Alzheimer's Dementia fully manifested

Question 37

what is the most common drug for AD?

Answer 37

Aricet

Question 38

what is the MOA of Aricet?

Answer 38

slows progression of the onset of dementia

Question 39

what is important for the perceptions of reality among patients with AD?

Answer 39

a patient's reality is their own and must not be changed nor discouraged

Question 40

why is reorientation unnecessary among patients with AD?

Answer 40

the brain is already deteriorating–it does not need to be corrected

Question 41

what is the most inconvenient problem among patients with AD?

Answer 41

wandering

Question 42

how can wandering be avoided?

Answer 42

- doorways must be disguised - patients should never be left alone - motion detector sensors

Question 43

how many hours can a search team have in looking for someone with AD / dementia?

Answer 43

6-12 hours

Question 44

what are the 4 roles of nurses for patients with dementia?

Answer 44

- magician - detective - carpenter *(use of tools to individualize care)* - jester

Question 45

what are the medications most commonly taken for anxiety?

Answer 45

- Ativan - Celexa - Xanax - Buspar

Question 46

syndrome of dementia includes ***at least one*** of these:

Answer 46

- aphasia - apraxia - agnosia - disturbances in executive functioning