Flashcards in T2-Blueprint Deck (57):
A mental state characterized by a disturbance of cognition, which is manifested as confusion, excitement, disorientation, and a clouding of consciousness
Are hallucinations and illusions common with delirium?
An acute and rapid (sudden or over several days) onset of disturbance in attention, awareness, and cognition
Delirium (another definition)
Symptoms become worse in late afternoon and evening
Some predisposing factors to delirium?
What are some meds to treat delirium?
-Benzo for substance withdrawal
-Antipsychotics (neuroleptics) for agitation, aggression, hallucinations, and illusions
What are some issues that could cause delirium?
-Illnesses that can cause delirium
-Fluid and electrolyte
Nursing process of delirium: look for the cause. What could be the cause of delirium?
A syndrome of chronic and possibly progressive intellectual and functional impairment involving memory, language, emotion, cognition, and changes in personality
How does the DSM-5 classify neurocognitive disorders?
Mild or major
Primary (organic) or secondary (another disease causes it)
DSM-5 classifies neurocognitive (NCD) as mild or major OR as primary or secondary. What are examples of secondary reasons?
Caused by another disease or condition such as HIV, depression, nutritional deficiency
Can NCD be due to Alzheimer's?
Yes, this would be classified as primary (organic)
what do we look for with history?
Mood, personality changes, cognitive changes
*Cognitive changes can be judgement, reasoning, memory, LOC, etc
NCD: Assesment Screen for ?
Anxiety and depression
NCD: Assessment What lab work is done in assessment?
Blood and urine
NCD: Assessment Why do we do a PET scan?
Reveal metabolic activity of the brain
NCD: Assessment Why do we do CT or MRI of brain?
View brain structures
NCD: Assessment Why do we do EEG?
Measure and record brain electrical activity
Why do we do lumbar puncture for spinal fluid
Screen for infection or hemorrhage or CSF pressure
What are risks for trauma?
Falls, wandering, confusion, poor coordination
What happens if the patient has "disturbed/altered thought process"
Disorientation, confusion, memory deficits, paranoria
What may the patient have if the patient has "disturbed sensory perception"
What if the pt. is aggressive, what is the risk?
Risk for other directed violence
What is the patients diagnosis if they have aphasia?
Impaired verbal communication
What if the patient has a self care deficit. What does this mean?
Inability to do ADLs
What if the patient has the diagnosis of situational low self esteem or grieving. What may they be expressing?
Shame and social isolation
What is the first and foremost thing to do?
Nursing care is directed to protect the client from ____ as well as promoting client ___ & ____; family education and support, and home safety
Promoting client SELF ESTEEM AND LIFE QUALITY
NCD meds: What are the 3 cholinesterase inhibitors
NCD meds: What is the NMDA receptor agonist?
NCD meds: What are the 4 antipsychotics?
NCD meds: What are the 2 SSRIs?
NCD meds: What is the TCA?
NCD meds: What are the 3 Benzos?
NCD meds: What are the 4 selective hypnotic?
NCD meds: What is the antidepressant?
NCD meds: What is the TETRAcyclic antidepressant?
NCD effect: Cannot speak or may forger meanings of words and names of things and the use for things; may be unable to express what they want or need
NCD effect: The inability to carry out motor activities and eventually unable care for self
NCD effect: The inability to recognize familiar objects
NCD effect: Mental skills that are coordinated in the brain's frontal lobe that include: planning, organizing, remembering details, curbing inappropriate speech/behavior, integrating past experiences with present action, managing time for tasks
NCD effect: Creating imaginary events to fill memory gaps to cover up/deny that memory problem exists
NCD effect: Persistently repeating the same word or idea in response to different questions
NCD effect phenomenon where symptoms of NCD worsen at sunset/evening
NCD: What are some ways sundowning is managed?
-Turn on lights to minimize shadows
-Do quiet activity to distract
-No caffeine in afternoon or evening
-No alcohol drinks
What is another name for depression?
Pseudodementia: Depression mimics the _____ noticed with a NCD
Is pseudodementa more rapid or slow than NCD?
Do pseudodementa patients experience confabulate?
No, that is what happens in NCD---Pseudodementa experience FORGETFULNESS
Are pseudodementa patients oriented to time and place?
How is the pseudodementa patients performance?
Variable (with nCD it is a consistently poor performance)
Pseudodementia patients get ____ as day progresses
NCD patients get ____ as day progresses
How is the appetite of pseudodemetia?
How is the appetite of NCD?
Unchanged appetite, but does not remember to eat
How is the concentration of pseudodementia?