neurcognitive

Question 1

what is aphasia?

Answer 1

loss of language ability. either expressive or receptive

Question 2

what is apraxia?

Answer 2

loss of purposeful movements

Question 3

what is agnosia?

Answer 3

loss of ability to recognize objects

Question 4

what is confabulation?

Answer 4

unconscious creation of storied or answers in place of actual memories

usually to maintain self esteem

Question 5

what is hyperorality?

Answer 5

tendency to put things in the mouth

Question 6

what are the Acetyl/cholinesterase inhibitors?

Answer 6

-donepezil
-rivastigmine
-galantamine

Question 7

what is the NMDA antagonists?

Answer 7

memantine

Question 8

what are common causes of delirium?

Answer 8

-medications
-INFECTIONS
-F and E imbalance
-hypoxia
-brain alterations

Question 9

what are s/s delirium

Answer 9

-disturbance in attention and awareness
-acute onset
-memory deficit
-disorientation
-language changes
-visuospatial changes
-delusions/hallucinations
-disturbances in sleep-wake pattern

Question 10

what are the four cardinal features of delirium?

Answer 10

1. acute onset
2. reduced ability to direct, focus, shift, and sustain attention
3. disorganized thinking
4. disturbance consciousness

Question 11

what are the nursing interventions to orient someone with delirium?

Answer 11

-encourage to express fears
-comfort measures
-frequent verbal orientation
-frequent brief interaction
-attempt consistency in nursing staff
-play non verbal music
-approach patient slowly and from the front
-allow TV during day

Question 12

what environmental nursing interventions should you make for a patient with delirium?

Answer 12

-adequate lighting
-easy to read calendars and clocks
-reasonable noise level
-sleep hygiene
- provide safety
-provide symptomatic and supportive care

Question 13

what are the pharmacological intervention for delirium?

Answer 13

-small doses of antipsychotics
-benzos
-sleep aids (mirtazapine)
-pain control
-idenitify drug drug interactions
-treat underlying cause

Question 14

what is dementia?

Answer 14

Degenerative, progressive neuropsychiatric disorder
that results in cognitive impairment, emotional and
behavioral changes, physical and functional decline,
and ultimately death

Question 15

what is the definition of neurocognitive disorder?

Answer 15

Progressive deterioration of cognitive functioning and
global impairment of intellect

Question 16

what is the deference in mild and major neurocognitive disorder?

Answer 16

mild doesn’t interfere with ADLs and major interferes with daily functioning

Question 17

what are the major neurocognitive disorders?

Answer 17

-alzheimers
-frontotemporal dementia
-dementia with lewy bodies
-vascular dementia
-TBI
-Substance induced dementia
-HIV
-prion disease
-parkinsons disease
-huntingtons disease

Question 18

s/s of alzheimers

Answer 18

-disturbances in executive functioning
-aphasia
-apraxia (loss of purposeful movement)
-agnosia (inability to recognize objects)
-memory impairment
-preservation
-hyperorality (put things in their mouth)

Question 19

r/f for alzheimers

Answer 19

-age
-family hx
-CCVD
-social engagement
-head injury
-HTN
-neuronal -degeneration
-genetics

Question 20

what is the etiology of alzheimers

Answer 20

tau proteins and beta-amyloid plaques create abnormal collections of protein threads inside nerve cells causing inflammation and brain atrophy

oxidative stress and free radicals

Question 21

what neurotransmitters are involved in alzheimers?

Answer 21

-less acetylcholine
-more glutamate

Question 22

what does acetylcholine do?

Answer 22

involves learning, memory, and mood

Question 23

what does glutamate do?

Answer 23

involved in cell signaling, learning and memory

Question 24

what does mild Alzheimer’s look like?

Answer 24

Forgetfulness, misplace articles, decreased recall, social
withdrawal, frustrated with self, changes may not be apparent
to others

Question 25

What does moderate Alzheimer's look like?

Answer 25

decreased ability for self-care; way-finding; disoriented to time and place; wandering, pacing, possible hallucinations or delusions begin, decreased visual perception leading to accidents; needs supervision; emotional lability-big swings; symptoms noticeable

Question 26

what does severe Alzheimer's look like?

Answer 26

cannot care for self; loss use of language; minimal long-term memory; constant complete care

Question 27

what should be included in the psychological assessment for someone with dementia ?

Answer 27

-suspiciousness, delusions, and illusions -hallucination -mood changes -anxiety -catastrophic reactions

Question 28

what are common defense mechanisms for someone with dementia?

Answer 28

-denial -confabulation -perseveration -avoidance of questions

Question 29

what are the priority care issues for someone with dementia?

Answer 29

-cognitive decline (mild) -safety from self (moderate) -physical needs (severe)

Question 30

what two classes of meds are used for alzheimers?

Answer 30

-acetylcholinesterase inhibitors -NMDA antagonists

Question 31

what meds are AChEI?

Answer 31

-donepezil -rivastigmine -galantamine

Question 32

do AChEIs decrease cognitive decline?

Answer 32

NOOOO!! only delay not decreaw

Question 33

what meds are NMDA antagonists?

Answer 33

-memantine

Question 34

what is the MOA of NMDA antagonists?

Answer 34

-restore function of damaged nerve cells and reduce abnormal excitatory signals of the NT glutamate

Question 35

what off label meds are used for dementia/alzheimers?

Answer 35

-antipsychotics -antidepressants -antianxiety -anticonvulsants