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NURS 406 > Neurocognitive Disorders > Flashcards

Neurocognitive Disorders Flashcards

Exam 4 (Final) (61 cards)

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1
Q

Cognition

A

Brain’s ability to process, retain, use information

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2
Q

Cognitive Processes

A

Processes: reasoning, judgment, perception, attention, comprehension, memory

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3
Q

Neurocognitive disorders

A

disruption or impairment in higher level brain functions

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4
Q

Delirium

A

Syndrome involving disturbance of consciousness with change in memory, orientation and language

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5
Q

How long is delirium?

A

Short period

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6
Q

Etiology of Delirium

A

infections, fluid and electrolyte imbalances, metabolic disturbance, hypoxia (COPD, emphysema, pneumonia), medications (Table 39.2), drug intoxication or withdrawal

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7
Q

Treatment for Delirium

A

Treat cause of delirium

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8
Q

Assessment of Delirium: History

A

medical history, medications

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9
Q

Assessment of Delirium: General appearance and motor behavior

A

disturbed psychomotor behavior (hypo or hyper), possible speech problems

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10
Q

Assessment of Delirium: Mood and affect

A

unpredictable shifts (agitated to lethargic)

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11
Q

Assessment of Delirium: Thought process and content

A

thoughts may be fragmented, severely impaired memory especially most recent.

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12
Q

Assessment of Delirium: Sensorium and intellectual processes

A

decreased awareness of environment

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13
Q

Assessment of Delirium: Judgment and insight

A

impaired

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14
Q

Assessment of Delirium: Roles and Relationships

A

inability to fulfill roles

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15
Q

Assessment of Delirium: Self concept

A

fear, feel threatened

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16
Q

Assessment of Delirium: Physiological and self care

A

sleep problems, ignore or fail to perceive internal body cues

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17
Q

Delirium: outcome identification

A

Freedom from injury *
Increased orientation, reality contact
Balance of activity and rest
Adequate nutrition and fluid balance
Return to optimal level of functioning

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18
Q

Delirium: Intervention

A

Promoting client safety
Managing client’s confusion: orienting cues; speaking in low, clear voice; avoiding sensory overload
Promoting sleep, proper nutrition

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19
Q

Delirium: Treatment

A

No specific medications

Supportive measures and treatment of precipitating factors are most effective & preferred

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20
Q

Dementia/ Alzheimer’s Disease

A

Progressive cognitive impairment*; language impairment

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21
Q

Issues involving Dementia/ Alzheimer’s Disease

A

Executive function

Aphasia

Apraxia

Agnosia

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22
Q

Executive function

A

(difficulty w/ ability
to think abstract, plan, initiate, sequence

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23
Q

Aphasia

A

(difficulty with speech)

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24
Q

Apraxia

A

(difficulty with movements on command)

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25
Agnosia
(loss of ability to identify things or objects)
26
Stages of Dementia/ Alzheimer’s Disease - How many and what are they
1. Mild 2. Moderate 3. Severe
27
Dementia/ Alzheimer’s Disease : Mild Stage
Loss of memory (forgetting recent conversations, events) Language difficulties Mood difficulties Personality changes Diminished judgement
28
Dementia/ Alzheimer’s Disease : Moderate Stage
Inability to retain new information Behavioral, personality changes Increasing long term memory loss Wandering, agitation, aggression, confusion Requires assistance with ADLS
29
Dementia/ Alzheimer’s Disease : Severe Stage
Gait and motor disturbances Bedridden Unable to perform ADLs Incontinence Requires long term care placement
30
Etiology of Dementia/ Alzheimer’s Disease: There are multiple factors involved in the development and progression of this disorder:
There are multiple factors involved in the development and progression of this disorder Genetic factors APOE-e4 gene Prior risk for head injury* Metabolic syndrome associated w/ microvascular changes B-amyloid protein accumulation Reduced neurotransmission which affects acetylcholine, norepinephrine, and serotonin
31
Dementia Assessment: History
client may be unable to provide accurate history.
32
Dementia Assessment: General appearance and motor behavior
aphasia; apraxia; uninhibited behavior
33
Dementia Assessment: Mood and affect
depression prevalent in early stages*;
34
Dementia Assessment: Thought process and content
impaired abstract thinking; delusions*, visual hallucinations*
35
Common Delusional Beliefs
Belief that their partner is engaging in marital infidelity Belief that other patients or staff members are impersonators Belief that people are stealing their belongings Belief that strangers are living in their home Belief that people on television are real and not actors
36
Most common type of hallucinations
Visual hallucinations are the most common
37
Example of a common visual hallucination
Frequent complaint that children, adults, or strange creatures are entering the house or the patient’s room
38
Dementia Assessment: Sensorium and intellectual processes
memory deficits; confabulation*
39
Dementia Assessment: Judgment and insight
: poor judgment
40
Dementia assessment: self concept
sadness; eventual loss of self-awareness
41
Dementia assessment: Roles and relationships
profoundly affected
42
Dementia assessment: Physiological and self care
disturbed sleep; incontinence; hygiene deficits
43
Dementia interventions
Safety Sleep, proper nutrition, hygiene, activity Environmental, routine structure Emotional support Interaction and involvement
44
Mental Health promotion: Measures to decrease risk of Alzheimer's disease
Regular participation in brain-stimulating activities Leisure-time physical activity during midlife Large social network
45
Role of the caregiver: Needs of caregivers
Education about dementia, required client care Assistance in dealing with own feelings of loss Respite to care for own needs*, role strain Support groups Assistance from agencies Support to maintain personal life
46
Self-Awareness Issues
Teaching clients with dementia can be frustrating. Discuss frustrations with a mentor or supervisor. May be difficult to deal with feelings about people who will never “get better and go home” Importance of dignity for client and family
47
Medications for Alzheimer's/Dementia
No cure exists, but medications and management strategies may temporarily improve symptoms
48
What does Alzheimer's do to levels of chemical messengers?
Alzheimer's disease decreases levels of a chemical messenger (acetylcholine) which is needed for alertness, memory, thought and judgment
49
Cholinesterase inhibitors
Cholinesterase inhibitors boost the amount of acetylcholine available to nerve cells by preventing its breakdown in the brain.
50
What do Cholinesterase inhibitors NOT do?
Cholinesterase inhibitors can not reverse Alzheimer's disease or stop the destruction of nerve cells.
51
Why do cholinesterase inhibitors eventually lose effectiveness?
Eventually these medications lose effectiveness because dwindling brain cells produce less acetylcholine as the disease progresses.
52
Example drugs for Alzheimer's/Dementia:
Galantamine (Razadyne)  Rivastigmine (Exelon)  Memantine (Namenda) Donepezil and Memantine (Namzaric) Donepezil (Aricept) 
53
Galantamine (Razadyne): what does it treat and
treats mild to moderate Alzheimer's.
54
Galantamine (Razadyne): how is it taken
It's taken as a pill once a day or as an extended release capsule twice a day
55
Rivastigmine (Exelon) 
 treats mild to moderate Alzheimer's disease.
56
Rivastigmine (Exelon): How is it taken?
It's taken as a pill. A skin patch is available that can also be used to treat severe Alzheimer's disease.
57
Memantine (Namenda)
treats moderate to severe Alzheimer's Disease.
58
Donepezil and Memantine (Namzaric)
) treats moderate to severe
59
Donepezil (Aricept)
 treats All stages of the disease. It's taken once a day as a pill.
60
Medication Most Common Side effects
Headache, dizziness, nausea and diarrhea.
61
How to mitigate medication side effects
Mitigation Strategies; Start at a low dose with slow titration up. Take with food. Over time side effects will dissipate

NURS 406 (29 decks)

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