[Exam 3] Chapter 24 - Cognitive Disorders Flashcards
1
Q
What is cognition?
A
Ability to process, retain, and use information. Cognitive abilities include reasoning, judgement, perception, attention, and memory
2
Q
What is a cognitive disorder?
A
Disruption or impairment in these higher level functions of the brain. Can have effects on ability to function in daily life. People forget names, and cannot perform tasks
3
Q
Cognitive disorders were previously categorized as what?
A
dementia, delirium and amnesic disorders. Now are just called neurocognitive disorders.
4
Q
Delirium: What is this?
A
Syndrome that involves disturbance of consciousness accompanied by a change in cognition. Usually develops over short period.
5
Q
Delirium: What will this person struggle with?
A
Difficulty paying attention, are easily distracted and disoriented, and may have sensory disturbances such as illusions, misinterpretations or hallucinations
6
Q
Delirium: How will they mistake electrical cord or banging of a laundry cart?
A
Appear as a snake and may mistake it for gunshot
7
Q
Delirium: Most common group for this?
A
Elderly patients. 14-24% of those admitted to hospital are delirious.
8
Q
Delirium: Percentage of those with general surgery, open heart surgery, and fractured hip surgery?
A
10-15%
30%
50%
9
Q
Delirium: Often times, teh causes of delirium are due to multiple stressors such as?
A
Trauma to CNS , drug toxicity or withdrawal, and metabolic disturbances
10
Q
Delirium: Risk factors for it?
A
severity of physical illness, older age, hearing impairment, decreased food and fluid intake, medications, and baseline cognitive impairments
11
Q
Delirium & Etiology: Almost always results from what?
A
identifable physiological, metabolic, or cerebral disturbance or disease or from dug intoxication or withdrawal
12
Q
Delirium & Etiology: Physiological or metabolic causes of this?
A
hypoxemia, electrolyte imbalance, renal failure, hypoglycemia, dehydration, sleep depirivation, thiamine or vitamin b12 deficiency
13
Q
Delirium & Etiology: systemic infection causes?
A
sepsis, uti, pneumonia
14
Q
Delirium & Etiology: cerebral infection causes?
A
meningitis, encephalitis, HIV syphilis
15
Q
Delirium & Etiology: intoxication causes of this?
A
anticholinergics, lithium, alcohol, sedatives, and hyponotics
16
Q
Delirium & Etiology: withdrawal causes of this?
A
alcohol, sedatives and hyponotics
17
Q
Delirium & Treatment/Prognosis: Primary tx for this is what?
A
To identify and treat any casual or contributing medical condition. Always a transient condition that clears with successful tx of underlying cause
18
Q
Delirium & Psychopharmacology: Tx for client with quiet, hypoactive delirium?
A
Need no specific pharmacologic tx aside from that indicated from the causative condition
19
Q
Delirium & Psychopharmacology: What may be used for someone to prevent inadvertent self-injury?
A
Sedation
20
Q
Delirium & Psychopharmacology: What medication will be used to decrease agitation and psychotic symptoms?
A
Antipsychotic med such as haloperidol (Haldol), in doses of 0.5 to 1 mg.
21
Q
Delirium & Psychopharmacology: Information about Benzodiazepines like Lorzepam (Ativan)?
A
They’ve been used but may worsen delirium, especially in elderly.
22
Q
Delirium & Psychopharmacology: When should benzodiazepines be used?
A
Resesrved for tx of sedative-hyponotic withdrawal.
23
Q
Delirium & Psychopharmacology: What may person with impaired liver or kidney struggle with?
A
Could have difficulty metabolizing or excreting sedatives
24
Q
Delirium & Psychopharmacology: How is delirium induced by alcohol treated?
A
Benzodiazepines
25
Delirium & Other Medical Tx: What other supporitve physical measures are needed?
Adequate nutritious food and fluid intake speed recovery. IV fluids or PRN may be necessary.
26
Delirium & History: What does nurse obtain from patient?
Alcohol and other drugs are obtained. Need to know OTC medications.
27
Delirium & General Appearance and Motor: How do they act motor wise?
Restless and hyperactive, frequently picking at bed clothes or making sudden uncontrolled attempts to get out of bed.
May also have slowed motor behavior, appearing sluggish and lethargic
28
What is acute confusion?
Abrupt onset of reversible disturbances of consciousness, attention, cognition, and perception that develop over shrot period of time
29
Delirium & General Appearance and Motor: How is speech?
Becomes less coherent and more difficult to understand. Client may perservate on single topic or detail, may be rambling and difficult to follow, or may have pressured speech that is rapid
30
Delirium & Mood/Affect: Mood here?
Have rapid and unpredictable mood shifts. Wide range of emotional responses like anxiety, fear, irritability, anger, euphoria, and apathy
31
Delirium & Thought Process/Content: How is it here?
Content in delirium unrelated to siutation and difficult to understand. Disorganized and makes no sense. Make experience delusions
32
Delirium & Sensorium / Intellectual Proceses: Initial signs of delirium is usually what?
Altered level of consciousness that is seldom stable and usually fluctuates throughout day.
33
Delirium & Sensorium / Intellectual Proceses: Orientation here?
Oriented to people but not time or place.
34
Delirium & Sensorium / Intellectual Proceses: Clients cannot focus on what?
Cannot focus, sustain, or shift attention effectivelly and there is impaired recent aand immediate memory.
35
Delirium & Sensorium / Intellectual Proceses: Examples of reactions to misperceptions they may experience?
May hear door slam and think its gunshot or see nurse reach for IV bag and believe nurse is about to strike them.
36
Delirium & Sensorium / Intellectual Proceses: What are some common illusions?
Include client believing that IV tubing or an electrical cord is a snake and mistaking the nurse for a family member.
37
Delirium & Judgement/Insight: How is judgement impaired here?
Cannot perceive potentially harmful siutations or act in their own best interests. May try to repeatdly pull out IV tubing
38
Delirium & Judgement/Insight: How is insight?
THose with severe delirium may have no insight. Mild delirium may recognize they are confused.
39
Delirium & Roles/Reltationships: Roles here?
Unlikely to fulfill their roles during the course of delirium
40
Delirium & Self-Concept: How do they feel?
Delirium has no effect on self-concept, but they often feel frightened or feel threatened
41
Delirium & Physiological/Self-Care: What changes occucr here?
Experience disturbed sleep-wake cycles that include difficulty falling asleep, daytime sleepiness, nighttime agitation. May also ignore internal body cues
42
Delirium & Intervention - Promoting Safety: What to know about medicines?
Should be used sparingly because it may worsen confusion and increase rf falls
43
Delirium & Intervention - Promoting Safety: What does the nurse teach patient?
To request assistance for activites such as getting out of bed.
44
Delirium & Intervention - Promoting Safety: When would restraints be used?
If the client is agitated or pulling at IV lines or catheters
45
Delirium & Intervention - Promoting Safety: What do you teach client and family?
Monitor chronic conditions
Visit physician regularly
Include all medications
Avoid alcohol/recreational drugs
Get adequate sleep
46
Delirium & Intervention - Managing Client's Confusion: Voice here?
Client speaks calmly and speaks in a clear low voice
47
Delirium & Intervention - Managing Client's Confusion: Example of what nurse should say?
I know things are upsetting and confusing right now, but your confusion should clear as you get better
48
Delirium & Intervention - Managing Client's Confusion: How to phrase questions?
Use short, simple sentences allowing adequate time for clients to grasp the content or respond to a question
49
Delirium & Intervention - Promoting Sleep/Nutrition: What does nurse monitor here?
Client's sleep and elimination patterns and food and fluid intake.
50
Delirium & Intervention - Promoting Sleep/Nutrition: Overall things to monitor here?
Monitor sleep/elimination
Monitor food and fluid intake
Provide periodic assitance to bathroom
Discourage daytime napping to help sleep
Encourage some exercise during day
51
Delirium & Intervention - Controlling environment to reduce sensory: Overall things to monitor here?
Keep environment noise to minimum
Monitor clients response to visitors
Validate clients anxiety and fears
52
Delirium & Intervention - Managing client confusions: Overall things to do here?
Speak in calm manner
Allow adequate time for client to comprehend
Allow client to make decisions
Provide orienting verbal cues
Use supportive touch
53
Delirium & Intervention - Promoting client's safety: Overall things to do here?
Teach the clients to request assistance
Provide close supervision to ensure safety during these activities
Promptly respond to clients call for assistance
54
Delirium & Evaluation: Successul tx of underlying causes of delirium causes what to happen to patient?
Return to their previous levels of functioning.
55
Delirium & Evaluation: Family must understand what health care practices are necessary to avoid recurrence including what?
Monitoring a chronic health condition, using meds carefully, or abstaining from alcohol or other drugs
56
Dementia: What is this?
Refers to disease process marked by progressive cognitive impairment with no change in level of consciousness
57
Dementia: Involves multiple cognitive impairments including what?
Memory impairment, with further cognitive disturbances my be seen
58
Dementia: What cognitive disturbances may be caused?
Aphasia
Apraxia
Agnosia
Disturbance in Executive Functioning
59
Dementia: What is Aphasia?
Deterioration of language function
60
Dementia: What is Apraxia?
Which is impaired ability to execute motor function despite intact motor abilities
61
Dementia: What is Agnosia?
Inability to recognize or name objects despite intact sensory abilities
62
Dementia: What are some disturbance sin executive functioning?
Ability to think abstractly and to plan, initiate, sequence, monitor, and stop complex behavior
63
Dementia: What does mild NCD refer to?
A mild cognitive decline, and a modest impairment of performance that doesn't prevent independent living but may require some accommodation or assitance
64
Dementia: What does major NCD refer to?
A significant cognitive decline and a substantial impairment in performance that interferes with ADLs
65
Dementia: What happens if dementia and delirium coexist?
Symptoms of dementia remain even when the delirium has cleared.
66
Dementia: Is deliriumm or dementia onset faster?
DElirium
67
Dementia: LOC here?
Not affected
68
Dementia: Speech here?
Normal in early stage, progressive aphasia in later stage
69
Dementia: Thought process here?
Impaired thinking, eventual loss of thinking abilitites
70
Dementia: Perception here?
Often absent, but can have paranoia, hallucinations, illusions
71
Dementia: Mood here?
Depressed and angry in early stage
Labile mood, restless pacing, angry outbursts in later stages
72
Dementia: Prominent early sign of this>?
Memory impairment . Have difficulty learning new material and forget previously learned material
73
Dementia: Aphasia usually begins with what?
Inability to name familar objects or people and then progresses to speech that becomes vague or empty with excessive use of terms such as it or things
74
Dementia: Clients may experience echolalia and palilalia which is what?
Echolalia - Echoing what is heard
Palilalia - Repeatings words or sounds over and over
75
Dementia: Apraxia may cause clients to lose ability to do what?
Perform self-care activites sucha s dressing or cooking
76
Dementia: Why is Agnosia frustrating?
May look at table and chair but are unable to name the
77
Dementia & Onset/Clinical: What are the stages of this?
Mild
Moderate
Severe
78
Dementia & Onset/Clinical: What happens in mild?
Forgetfulness if hallmark of beginning. Exceeds normal occasional forgetfulness. Cannot find words frequently loses objects, adn experiences anxiety about these losses. Avoid Social settings
79
Dementia & Onset/Clinical: What happens in moderate stage?
Progressive memory loss. Cannot perform complex tasks but remains oriented. Still recognizes familiar people
80
Dementia & Onset/Clinical: What happens toward the end of the moderate stage?
Person loses ability to live independently and requires assistance because of disorientation to time and loss of information . Remain in community if caregiver support available
81
Dementia & Onset/Clinical: What happens in severe stage
Personality and emotional changes. May be delusional, wandere at night, forget names, and require assitance with ADL. Live in nursing facilitites at this stage
82
Dementia & Etiology: Metabolic activity here?
Decreased in brains of clients with dementia. Not known whether dementia causes decreased metabolic activity or if decreased metabolic activity results in dementia
83
Dementia & Etiology: Genetic compoent has been identifeid for some, such as what?
Huntington Disease
ABnormal APOE gene linked with Alzheimers.
HIV or Creutzfeldt-Jakob didsease
84
Dementia & Etiology: What are some common types of dementia?
```
Alzheimer Disease
NCD with Lewy Bodies
Vasculat Dementia
Frontotemporal Lobar Degeneration
Prion Disease
HIV Infection
Parkinson Disease
Huntington Disease
```
85
Dementia & Etiology - Alzheimer Disease: What is this?
Progressive brain disorder that has gradual onset but causes increase decline in functioning, including loss of speech/motor function, and profoudn personality changes including paranoid, delusions, hallucinations and inattention to hygiene
86
Dementia & Etiology - Alzheimer Disease: What is this evidenced by?
atrophy of cerebral neurons, senile plaque deposits and enlargement of 3rd and 4th ventricles of brain
87
Dementia & Etiology - Alzheimer Disease: RF this increases with what?
age,
88
Dementia & Etiology - Alzheimer Disease: average duration from onset of symptoms to death is what?
8-10 years
89
Dementia & Etiology - Lewy Body Dementia: What is this?
Involves progressive cognitive impairment and extensive neuropsychiatric symtoms as well as motor symptoms
90
Dementia & Etiology - Lewy Body Dementia: What is common here?
Delusions adn visual hallucinations
91
Dementia & Etiology - Lewy Body Dementia: What is more pronounced that cognitive deficits?
Functional impairments
92
Dementia & Etiology - Lewy Body Dementia: How is this passed?
Several risk genes have been identified, but can occur in families though that is less common with no family hx
93
Dementia & Etiology - Vascular Dementia: What is this?
Symptoms similar to those of Alzheimer. Onset typically abrupt, followed by rapid changes in function, a plateau, more abrupt changes, and then another leveling off and so on
94
Dementia & Etiology - Vascular Dementia: What does CT/MRI show?
Multiple vascular lesions of the cerebral cortex and subcortical structures resulting from decreased blood supply
95
Dementia & Etiology - Frontotemporal Lobar Degeneration: What is this?
degenerative brain disease that affects frontal and temporal lobes and results in signs close to alzheimer disease
96
Dementia & Etiology - Frontotemporal Lobar Degeneration: Early signs of this?
personality changes, loss of social skills, and inhibitions ,emotional blunting, and language abnormalities
97
Dementia & Etiology - Frontotemporal Lobar Degeneration: Onset and how long to die?
Onset is 50-60 years old
Deah ocurs in 2-5 years
98
Dementia & Etiology - Frontotemporal Lobar Degeneration: How is this passed?
Strong genetic ocmponent, and tends to run in families
99
Dementia & Etiology - Prion Diseases: What is this?
Caused by prion that can trigger normal proteins in the brain to fold abnormally. CJD is most common priod disease affecting humans
100
Dementia & Etiology - Prion Diseases: Onset age?
40-60 years
101
Dementia & Etiology - Prion Diseases: Signs?
Altered vision, loss of coordination or abnormal movements, and dementia that usually progresses rapidly.
102
Dementia & Etiology - Prion Diseases: Causes of encephalopathy?
Infectious particle rsistant to boiling, some disinfectants and some UV radiation
103
Dementia & Etiology - Prion Diseases: What are some other prion diseases?
mad cow disease and kuru
104
Dementia & Etiology - HIV: This type of demetia can result in what symptoms?
those ranging from mild sensory impairemnt to gross memory and cognitive deficits to severe muscle dysfunction
105
Dementia & Etiology - Parkinson Disease: What is this?
slowly progressive neurologic condition characerized by tremor, rigidity, bradykinesi and postural instability .
106
Dementia & Etiology - Parkinson Disease: signs of this?
cognitive and motor slowly, impaired memory, and impaired exectutive functioning
107
Dementia & Etiology - Huntington Disease: What is this?
Inherited, dominant gene disease that primarily involves cerebral atrophy, demyelination and enlargement of the brain ventricles.
108
Dementia & Etiology - Huntington Disease: Signs?
Initially choreiform movements and invovle facial contortions, twisitng, turning, adn tongue movements.
109
Dementia & Etiology - Huntington Disease: Age for htis?
30-40 and may last 10-20 years before death
110
Dementia & Related Disorders: Long term use of alcohol that results in dementia is known as?
Koraskoff syndrome or dementia
111
Dementia & Related Disorders: Mild or major CND due to another medical condition is cause dby waht?
diseases such as brain tumor, brain metastasis, subdural hematoma, arteritis, renal failure.
112
Dementia & Related Disorders: Unsppecified NCD characterize dby what?
neurocognitive symptoms that cause person distress or impairment but do not meet criteria for another other
113
Dementia & Related Disorders: What were previously classified as amnestic disorders?
Neurocognitive deficitis due to storoke, head injuries, carbon m onoxide poisoning, or brain damage
114
Dementia & Related Disorders: How many poeple have this?
5 million
115
Dementia & Related Disorders: Most common type inn north america?
Alzheimer
116
Dementia & Cultural Considerations: Why should you be aware fo this?
Because people from other countires may not be able to tell you who the US presient is
117
Dementia & Tx and Prognosis: How can vascular dementia be treeated?
Appropriate tx of underlying vascular condition (changes in diet, exercise, control of hypertension).
118
Dementia & Tx and Prognosis: What neurons are decreased here?
Acetylcholine, Dopamine, Norepinephrine and Serotonin.
119
Dementia & Tx and Prognosis: What medications have shown modest therapeutic therapeutic effects and slow progress of dementia?
Donepezil (Aricept)
Rivastigmine (Exelon)
Galantamine (Reminyl, Razadyne, Nivalin)
These are cholinesterase inhibitors
120
Dementia & Tx and Prognosis: What does Tacrine (Cognex) do?
Cholinesterase Inhibitor. Elevates liver enzymes in about 50% of clients using it.
121
Dementia & Tx and Prognosis: What is Memantine (Namenda)
NMDA receptor antagonist that can slow progression of Alzheimers.
122
Dementia & Tx and Prognosis: Donepezil (Atricept) dosage
5-10 mg orally
123
Dementia & Tx and Prognosis: Donepezil (Aricept) nursing consideratiosn
nausea, diarrhea, and insomnia. Test stools periodically for GI bleeding
124
Dementia & Tx and Prognosis: Rivastigmine (Exelon) dosage
3-12 mg orally divided into two doses
125
Dementia & Tx and Prognosis: Rivastigmine (Exelon) nursing considerations
monitor for nausea, vomiting, abdominal pain, los of appetite
126
Dementia & Tx and Prognosis: Memantine (Namenda) dosage
10-20 mg divided into two doses
127
Dementia & Tx and Prognosis: Memantine (Namenda) nursing considerations
monitor for hypertension, pain, headache, vomiting, constipation and fatigue
128
Dementia & Tx and Prognosis: What to do about antidepressants?
Are effective for significant depressive symptoms but can cause delirium
129
Dementia & Tx and Prognosis: SSRI used because
they have fewer side effects
130
Dementia & Tx and Prognosis: Why would antipsychotics be used?
Manage psychotic symptoms of delusions, hallucinations or paanoia and other behaviors sucha s agitation or aggression
131
Dementia & Tx and Prognosis: What antipsychotics have been used
Haloperidol (Haldol0
Olanzapine (Zyprexa)
Risperidone (Risperdal)
Quetiapine (Seroqual)
132
Dementia & Tx and Prognosis: Why would lithium carbonate, carbamazepine (Tegretol) and valporic acid (Depakote) be used?
help stabilize affective lability and diminish aggressive outbursts
133
Dementia & Tx and Prognosis: Bebnzodiazepines used cautiously because why
they may cause delirium and can worsen already compromised cognitive abilities
134
Dementia & Tx and Prognosis: What has been approved to tx delusiosn and hallucinations that some experience with parkinson disease?
Pimavanserin (Nuplazid). One 34 mg capsule per day is recommended.
135
Dementia & Assessment: How to approach client during meeting?
Take frequent breaks so they don't become confused or tire out. Ask simple questions.
136
Dementia & History: How will you get your information?
From family, friends, or caregivers
137
Dementia & Appearance/Motor: Speech here?
Aphasia, conversation becomes repetitive and speech may evantually become slurred, followed by total loss of language
138
Dementia & Appearance/Motor: Motor ability?
Loss of ability to perform familar tasks (apraxia). Cannot imitate task when others demonstrate it. ALso have uninhibited beavior include making inappropriate jokes.
139
Dementia & Mood/Affect: Mood at first?
Show anxiety and fear over beginning losses of memory and cognitive function. Mood becomes more labile over time. EMotional outbursts common.
140
Dementia & Mood/Affect: Start to demonstrate catastrophic emotional reactions that include what?
Verbal or physical aggression, wandering at night, agitation, or other behaviors that seem to indicate loss of personal control
141
Dementia & Thought Process/Content: Ability to think here?
Is impaired resulting in loss of ability to plan, sequence, monitor, initiate or stop complex behavior . Cannot solve problems
142
Dementia & Thought Process/Content: DElusions here?
As dementia progresses, this occurs. May accuse others of stealing objects he or she has lost
143
Dementia & Sensorium/Intellectual PRocesses: What does client lose?
Intellectual function, which means loss of their abilities.
144
Dementia & Sensorium/Intellectual PRocesses: Confabulation occurs. What is this?
When they make up answers to fill in memory gaps.
145
Dementia & Sensorium/Intellectual PRocesses: Agnosia occurs. What is this?
Clients lose spatial relationships, which is often evidenced by deterioration of ability to write or draw simple objects
146
Dementia & Judgement/Insight: How is judgement a problem?
They underestimate risks and unrealistically appraise their abilities, which result in a high risk for injury. Cannot evluate siutations for risks or danger
147
Dementia & Judgement/Insight: Insight here?
Limited. May be aware of problems with memory and cognition and may worry that they are losing their mind. These concerns about ability to function diminish and they have no awareness of this.
148
Dementia & Self-Concept: How is this?
May be angry or frustrated initially. Soon, lose that awareness of self and cannot recognize themselves in the mirror
149
Dementia & Physiological/Self-Care Considerations: What do they often experience here?
Disturbed sleep-wake cycles. Nap during the day and wander at night. May also ignore internal cues such as hunger or thirst.
150
Dementia & Outcome Identification: Outcomes must focus on what?
Client's medical condition or deficits.
151
Dementia & Outcome Identification: What does psychosocial care involve?
Maintaining the client's independence as long as possible, validating the client's feelings and keeping the client involved in the environment.
152
Dementia & Outcome Identification: Some treatment outcomes may include what?
Client will remain injury free.
Maintain adequate balance of activity and rest
Client will function as independetly as possible
Client will feel respected and supported
Client will remain involved in their surroundings
153
Dementia & Intervention: Interventions are rooted in belief of what?
That clients with dementia have personal stregnths. Focus on demonstrating caring, keeping clients involved by relating to environment, and validating feelings and dignity of clients.
154
Dementia & Intervention - Promoting Client Safety: Safety considerations involve what?
protecting against injury, meeting physiolgoical needs, and managing risks posed by environment, including internal stimuli.
155
Dementia & Intervention - Promoting Client Safety: Example of how client living at home does not exercise normal caution?
Client may forget food cooking on stove and client living in residental care may leave for a wlak in cold weater without coat and gloves
156
Dementia & Intervention - Promoting Client Safety: Assistance or supervision that is unobstrusive as possible does what for client?
from injury while preserving their dignity
157
Dementia & Intervention - Structing Environment/Routine: What must nurse know?
Whether client prefers a tub bath or shower and washes at night or in the morning and include those preferences in the clients care.
158
Dementia & Intervention - Structing Environment/Routine: What to know about tolerance?
They can tolerate less stimulation when they are fatigued, hungry, or stressed. As dementia prpogresses, tolerance for environmental stimuli decreases
159
Dementia & Intervention - Providing Emotional Support: This relationsbip involves empathic caring, which is what?
Includes being kind, respectful, calm, and reassuring and paying attention to the client.
160
Dementia & Intervention - Providing Emotional Support: How can nurse convey reassurance?
By approaching the client in a calm, supportive manner as if nurse and client are a team. A "we can do it together" approach
161
Dementia & Intervention - Providing Emotional Support: If client is confused about getting dressed, what could nurse say?
I'll be glad to help you with that shirt. i'll hold it for you while you put your arms in the sleeves
162
Dementia & Intervention - Providing Emotional Support: Why is supportive touch effective?
Can provide reassurance and convey caring when words may not be understood
163
Dementia & Intervention - Promoting Interaction and Involvement: What occurs in the psychosocial model of dementia care?
Nurse or caregiver plans activites that reinforce the client's identity and keep him or her engaged and involved in business of living
164
Dementia & Intervention - Promoting Interaction and Involvement: Example of nurse using psychosocial model of dementia care?
Client with an interest in history may enjoy documentary programs on televisions
165
Dementia & Intervention - Promoting Interaction and Involvement: What is reminiscence therapy?
Thinking about or relaitng personally significant past experiences
166
Dementia & Intervention - Promoting Interaction and Involvement: Why is reminiscence therapy effective?
Effective for clients with dementia. Therapy encourages family and caregivers to also eminisce with the client. Promote clients use of memory
167
Dementia & Intervention - Promoting Interaction and Involvement: Example of why nurse must listen carefully?
As dementia progreses, they may have trouble speaking. Listen to try to determine meaning behind what is being said
168
Dementia & Intervention - Promoting Interaction and Involvement: What should nurse do when they cannot understand the meaning?
"Can you show me what yoou mean or where you wwant to go?
169
Dementia & Intervention - Promoting Interaction and Involvement: Interacting with clients with dementia often means what?
Dealing with thoughts and feelings that are not based in reality but arise from clients suspicion or chronic ocnfusion
170
Dementia & Intervention - Promoting Interaction and Involvement: What does distraction involve?
Shifting the client's attention and energy to a more neutral topic.
171
Dementia & Intervention - Promoting Interaction and Involvement: Example of distraction technique?
Client may display catatrophic reaction to current siutation suhc as thinking food tastes like poison. Nurse would interevene and try to find something to eat that nurse wants.
172
Dementia & Intervention - Promoting Interaction and Involvement: What is timy away?
Involves leaving clients for short period and then returning to them to reengage in interaction. Leaves fro 5-10 mins and then returns
173
Dementia & Intervention - Promoting Interaction and Involvement: What is going along?
Providing emotional reassurance to clients without corecting their misperception or delusion. Does not engage with them. Would just go along with it.
174
Dementia & Community-Based Care: Adult day care centers provide what?
supervision, meals, support, adn recreational activites in group settings. Client's may attention for few hours a week or full-time.
175
Dementia & Community-Based Care: Residental facilities are available for who?
Clients who do not have in-home caregivers or whose needs have progressed beyond the care that could be provided at home.
176
Dementia & Mental Health Promotion: People with what are at increased risk for dementia?
Elevated levels of plasma homo cysteine
177
Dementia & Role of Caregiver: Who is this most often?
2/3 caring for family members are women and over 1/3 are adult daughters
178
Dementia & Role of Caregiver: When is role strain identified?
When demands of providing care threaten to overwhelm a caregiver. This includes constant fatigue that is unrelieved by rest, increased use of alcohol and social isolation
179
Primary goals of nursing care for clients with delirium are what
protection from injury, management of confusion, and meeting physiological and psychological needs
180
Psychosocial model for probiding care for people with dementia addresses needs for what
safety, structure, support, interpersonal involvement and socil interaction
181
Areas for teahcing for caregivers includes what?
Monitoring the client's health, avoiding alcohol and recreational drugs, ensuring adequate nutrition, schedulign regular checkps, getting adequate rest, promoting actiity and socialization and helping the client maintain independence
