What is the definition of delirium?
A disturbance in attention that develops over a short period of time, with an additional disturbance in cognition.
What is the prevalence of delirium among clients older than 85 years?
About 14%.
What percentage of post-operative patients experience delirium?
15–53%.
What is dementia defined as by the American Psychiatric Association?
Significant cognitive decline from previous level of performance in one or more cognitive domains.
Name the cognitive domains affected by dementia.
- Complex attention
- Executive function
- Learning and memory
- Language
- Perceptual-motor
- Social cognition
What distinguishes delirium from dementia in terms of onset?
Delirium has an onset of hours to days, while dementia has an onset of months to years.
What are some contributing factors to delirium?
- Dehydration
- Hypoglycemia
- Fever
- Infection
- Hypotension
- Drug reaction
- Head injury
How does cognition differ between delirium and dementia?
Delirium has impaired memory, judgment, attention, calculations, while dementia also includes impaired abstract thinking and agnosia.
True or False: The level of consciousness is altered in delirium.
True.
What is the prognosis of delirium compared to dementia?
Delirium can be reversed with intervention, while dementia progresses.
List some types of neurocognitive disorders according to DSM-5.
- Alzheimer’s disease
- Frontotemporal lobar degeneration
- Lewy body disease
- Vascular disease
- Traumatic brain injury
- Substance/medication use
- HIV infection
- Prion disease
What is the strongest risk factor for Alzheimer’s disease?
Age.
What are the manifestations of mild Alzheimer’s disease?
- Friends and family notice subtle changes
- Misplaces objects
- Forgets names
- Trouble with planning/organizing
- Makes up words (neologisms)
What characterizes severe Alzheimer’s disease?
Difficulty communicating, responding to their environments, and controlling movement.
What are the manifestations of vascular dementia?
- Cognitive decline
- Decreased processing speed
- Impaired executive function
What are some common emotional disturbances associated with delirium?
- Rapid mood swings
- Aggressiveness
- Fearfulness
- Anxiety
- Paranoia
Fill in the blank: The nursing process involves recognizing cues during a comprehensive assessment related to _______.
[mood, cognition/perception, physical needs, communication, physical symptoms, mobility, vital signs, diagnostic/laboratory tests]
What safety measures should be implemented in a home setting for clients with neurocognitive disorders?
- Ensure supervision
- Prevent elopement
- Evaluate house for safety hazards
- Assure locks and windows are secure
What is the role of the nurse in caring for clients with neurocognitive disorders?
- Provide equitable and sensitive care
- Knowledge
- Compassion
- Advocacy
What are some pharmacologic actions for treating delirium?
Treat cause and use benzodiazepines for delirium.
What is the purpose of using the MMSE in assessing Alzheimer’s disease?
To determine the stage of cognitive decline.
True or False: Cognitive decline in Lewy body dementia precedes motor manifestations.
True.
What dietary approach can help delay progression of neurodegenerative diseases?
Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND).
What is a common manifestation of frontotemporal lobar dementia?
Disinhibition and loss of empathy.
