Quiz 3 Flashcards
(23 cards)
Dysarthria-
slurred speech, slower responses –due to disturbance in muscular control due to damage to central or peripheral nervous system
Dysphasia –
difficulty expressing or comprehending verbal or written language due to brain lesion of injury
Interventions for patients with dementia
a. Nutritional supplements, therapeutic exercise, PT, OT, activities, safe environment, prevent abuse,
Causes for impaired cognition
fluid/electrolyte imbalance medications congestive heart failure hyperglycemia, hypoglycemia hyperthermia/hypothermia hypercalcemia/hypocalcemia hypothroidism decreased cardiac function decreased respiratory function decreased renal function CNS disturbances emotional stress pain malnutrition dehydration Anemias infection hypotension trauma malignancy alcoholism hypoxia toxic substances
a. Delirium –
rapid change in disposition, disruption of the brain due to something, can be reversed if treated promptly
b. Dementia –
slow change, due to damage of brain tissue from degenerative diseases
- Signs and Symptoms of Parkinson’s Disease
a. Tremors and shuffling gate
preventing/managing sundowner
placing familiar objects in persons room physical activity in the afternoon adjust the lighting in environment night light on throughout the night frequent contact with person using touch to provide human contact ensure temp is within comfort range conrolling nnoise and traffic flow in evening ensuring person has basic needs met
- Risk factors for Transient Ischemic Attacks (TIA) – temporary or intermittent neurological event that can result from any situation that reduces cerebral circulation.
a. Hyperextension and flexion of the head, reduced blood pressure resulting from anemia and certain drugs (diuretics and antihypertensive), smoking causes vascular constriction, sudden stranding from a prone position
b. Light headedness, dizziness, headache, drop attack, memory and behavioral changes
c. Increase risk of CVA (cerebrovascular accident) – strokes
- What are the major signs of a stroke
a. FAST – face drooping, arm weakness, speech difficulty, time to call 911
b. Paralysis, aphasia (loss of ability to understand or express speech)
FAST acronym - FAST
– face drooping, arm weakness, speech difficulty, time to call 911
- When does rehab start in a stroke patient?
Once the patient regains consciousness and stabilizes
- What care considerations are there in a patient starting rehab for stroke patient
a. Attention span is reduced
b. Long/complicated directions may be confusing
c. Recent events/explanations are forgotten (older events may be remembered)
d. Inability to transfer information from one situation to another
e. Confusion, restlessness, irritability
- Contributing factors to a stroke
a. Hypertension, severe arteriosclerosis, diabetes, gout, anemia, hypothyroidism, silent myocardial infarctions, TIA’s , dehydration, smoking
Interventions to prevent/decrease incidence of aspiration
a. Thicken liquids – speech language pathologist performs swallow study
b. Make sure sitting upright when eating
c. Pureed foods, mechanically altering food
d. Not rushing meals, small bites
- Risk factors for constipation
a. Dehydration
b. lack of dietary fiber
c. physical inactivity
d. medication side effects (Opioids)
e. regular use of laxatives (cause dependence and decreased bowel function)
- Signs and Symptoms of cholelithiasis (formation of gallstones)
– pain, nausea, vomiting, pain
Gallstones- hardened deposits of digestive fluid
Incidence increases with age
Risk- Female, Fat, Fair skin, Forty – 4 f’s
S/S: pain, nausea, vomiting, pain
Management: diet, nutrition
Treatment: if stone gets stuck in duct, might have to remove gallbladder
Upper right quadrant
- Gastrointestinal changes with aging
changes in pancreas, liver, gallbladder and stomach, tongue, esophagus, intestins
Stomach - decreased motility, higher pH, decline in hydrochloric acid, decline in pepsin, slower peristalsis
a. Atrophy of the tongue affects taste buds and decreases taste sensation.
b. Saliva production decreases & Swallowing may be difficult. – decreases motility of food down the mouth
c. Weaker esophageal contractions and weakness of the sphincter-Risk for aspiration and indigestion
d. Stomach motility decreases
e. Decreased elasticity of the stomach
i. Fewer cells on absorbing surface of intestinal wall impact the absorption of dextrose and vitamins B and D
j. Slower peristalsis, inactivity, reduced food/fluid intake, drugs, and low-fiber diet
k. Sensory perception decreases
l. Gallbladder, Bile salt synthesis decreases
m. Pancreatic changes of fibrosis, atrophy, fatty acid deposits
n. Liver size decreased, function should remain within normal limits; blood flow reduced due to decreased cardiac output
o. Pancreas creates enzymes, Slower moving pancreas – type II diabetes, trouble breaking down sugar
p. Liver – decreased in size, blood flow reduced
- Causes of incontinence
DIAPERS delirium/confusional state infection atrophic urethritis/vaginitis pharmeceuticals excess urine output restricted mobility stool impaction
weakening of the pelvic muscles, enlargement of the prostate, irritations or spasms of the bladder wall, bladder neck obstructions, neuro – cerebral cortex lesions, MS, dementia
- Nursing interventions for stress incontinence
a. kegel exercises – need to ensure they are doing them correctly
b. stopping stream of urine to feel the correct muscles of pelvic floor
- Causes of urinary retention
a. Bladder blockage
b. Medications
c. Nerve issues
d. Infections/swelling
- Age-related physiological changes in the urinary system
a. Hypertrophy and thickening of the bladder muscle – decrease bladder ability to expand
b. Reduces storage capacity
c. Increased urinary frequency
d. Females - Weakening of pelvic diaphragm
e. Males – prostatic hypertrophy – BPH – enlarged prostate
f. Kidney filtration decreases – affects the ability to eliminate drugs
g. Decrease in renal mass
h. Decreased tubular function
i. Incontinence NOT NORMAL
- Understand the symptoms associated with the stages of Alzheimer’s
Stage 1 - normal adult - no impairment
stage 2 - normal older adult - self report memory impaiment - no objective impairments
stage 3 - cognitive impairments recognized by others - early AD
stage 4 - withdrawl, denial, depression, inability to perform ADLS - mild AD
stage 5 - disoriented to time and place, need assistance with clothing - moderate AD
stage 6 - forgets name of spouse and family members, peronsality changes - moderately severe AD
stage 7 - loss of verbal and psychomotor skills, incontinence needs total assistance - severe AD
