Impaired Cognition/Alzheimer's

Question 1

Dementia characteristics?

Answer 1

Loss of memory
Language
Judgment 
Orientation 
Reasoning 
Attention

Question 2

How old are older clients?

Answer 2

Over 65

Question 3

What is the etiology of dementia?

Answer 3

Neurodegenerative Condition (AD) is most common
Vascular disorders - second leading cause (stroke)

Question 4

Risk factors for dementia

Answer 4

Aging = greatest risk
Family Hx
Diabetes

Question 5

Delirium comes on

Answer 5

abruptly

Question 6

Sometimes dementia is mistaken for

Answer 6

Depression

Question 7

What are other risk factors for dementia?

Answer 7

obesity, smoking, cardiac dysrhythmias, CAD, hypertension, hypercholesterolemia

Question 8

Dementia clinical menifestations are

Answer 8

Insidious or abrupt

Question 9

What is the most common form of dementia?

Answer 9

Alzheimer’s

Question 10

What is the characteristic of alzheimer’s

Answer 10

chronic, progressive, degenerative-most common form of dementia

Question 11

What is early on set alzheimer’s disease

Answer 11

Early-onset AD-people younger than 60 years old

Question 12

Early-onset AD is a ______ % other family members will be diagnosed

Answer 12

50%

Question 13

What is late-onset AD?

Answer 13

Late-onset AD-people older than 60 years old

Question 14

Familial Alzheimer’s disease [FAD]

Answer 14

inheritance type. Most have early onset

Question 15

What are the changes in the brain structure?

Answer 15

1. Amyloid plaques
2. Neurofibrillary tangles
3. Loss of connections b/t neurons
4. Death of neurons

Question 16

Overproduction of ________ is a risk factor for AD

Answer 16

amyloid protein

Question 17

What are the 3 stages of AD?

Answer 17

Mild
Moderate
Severe

Question 18

What is the rate of progression for AD

Answer 18

3 to 20 yrs

Question 19

Can you stop the progression of the disease.

Answer 19

No.

Question 20

Alzheimer’s is really common is pts that have had

Answer 20

Brian injuries

Question 21

How is AD diagnosed. The only true way.

Answer 21

autopsy. Before death it is diagnosed with process of elimination.

Question 22

Early signs and symptoms.

Answer 22

Forgetfulness (short-term)

Memory

Question 23

Mild:

Answer 23

Forgetfulness

Question 24

Moderate:

Answer 24

agitated, trouble with recognition

Developmental (3yrs)

Question 25

Severe:

Answer 25

not being able to ALDS, immobile, incontinence, feeding

Question 26

Are women or man more likely to have AD

Answer 26

women

Question 27

The average lifespan after diagnosis is

Answer 27

4 to 8 yrs

Question 28

What is retrogenesis?

Answer 28

The decline of life. In reverse order. Going back to infancy.

Question 29

Seen pts with lower

Answer 29

Socioeconomic status and lower education level

Question 30

Diagnostic criteria

Answer 30

Preclinical stage Mild cognitive impairment Dementia

Question 31

During preclinical stages

Answer 31

look at the plaque. CT scan and MRI

Question 32

Midl cognitive impairment

Answer 32

Second stage, forgetting, troubled higher thinking, and executive cognition decline

Question 33

What is the nursing goal for AD?

Answer 33

Controlling undesirable behaviors and providing support for the family/caregiver.

Question 34

Drug therapy for decreased memory and cogntion

Answer 34

Donepezil (Aricept) Rivastigmine (Exelon) Patch Galantamine (Razadyne) Memantine (Namenda)

Question 35

Drug therapy for depression

Answer 35

Sertraline (Zoloft) Citalopram (Celexa) Trazodone (Desyrel) for sleep also

Question 36

Drugs for behavioral problems

Answer 36

Risperidone (Risperdal) Olanzapine (Zyprexa) Quetiapine (Seroquel)

Question 37

Drug therapy for sleep disturbance

Answer 37

zolpidem (ambien)

Question 38

Drugs are not a cure but to ______ behaviors

Answer 38

control

Question 39

Important subject data to find out?

Answer 39

``` Orientation and alert Can you tell me what day it is? Who are you? Full name? What year were you born in? Who is this who came to visit with you today? (Relevant to stage) ```

Question 40

Important objective data to find out?

Answer 40

Agitated Frustration Crying (antidepressants) Look at the appearance

Question 41

What are some nursing diagnoses?

Answer 41

Impaired memory Self-neglect Risk for injury Wandering

Question 42

What is a goal for the pts

Answer 42

Keep safe

Question 43

What is a goal for the caregiver

Answer 43

Stay healthy

Question 44

Implementations

Answer 44

Health Promotion Acute Intervention Ambulatory and home care.

Question 45

What are some health promotions

Answer 45

``` Crossword puzzles Not harmful supplements Read a lot Learn new skills Exercise regularly (30 q 3 days) Social activités are important ```

Question 46

What are signs of depression?

Answer 46

Loss of interests Insomnia Appetites

Question 47

What are some acute interventions?

Answer 47

hospitalization Hospice (q 6 months) gives family a break Respite: Staying in the hospital.

Question 48

What is the most frequent complication of hospitalization in older pts?

Answer 48

Delirium

Question 49

What is delirium?

Answer 49

acute mental confusion, temporary, life-threatening.

Question 50

Clinical manifestations of delirium?

Answer 50

Agitation Hallucinations Hyperactivity Lethargy

Question 51

Acute delirium?

Answer 51

Pts that wakes up from surgery, and pulls off all lines.

Question 52

What time frame does delirium develop over?

Answer 52

2-3 days

Question 53

Early signs in delirium?

Answer 53

Look at latest labs Surgery Infection

Question 54

What is the treatment for delirium?

Answer 54

Treating the physiological symptoms. Temp, etc.

Question 55

What is confabulation?

Answer 55

Making up stories. | Loss of memories so they try to fill in the gaps.

Question 56

What is preservation?

Answer 56

Repeating things multiple times.

Question 57

What is executive functioning?

Answer 57

Planning organizing thoughts in the brain.

Question 58

What is aphasia?

Answer 58

Loss of language and ability to speak

Question 59

What is apraxia?

Answer 59

Not able to move. ADLS

Question 60

What is agnosia?

Answer 60

Not able to identify familiar objects or people

Question 61

What is hyperorality?

Answer 61

Excessively putting things in the mouth. Pleasure

Question 62

What is hypermetamorphosis?

Answer 62

Wanting to touch everything

Question 63

What is sundowning?

Answer 63

getting crazy though the night.

Question 64

What is Agraphia?

Answer 64

Losing ability to Writing, reading,

Question 65

What is retrogenesis?

Answer 65

Reverting back to infancy. Reverse developmental stages.