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Flashcards in T2-Blueprint Deck (57):
1

A mental state characterized by a disturbance of cognition, which is manifested as confusion, excitement, disorientation, and a clouding of consciousness

Delirium

2

Are hallucinations and illusions common with delirium?

Yes

3

An acute and rapid (sudden or over several days) onset of disturbance in attention, awareness, and cognition

Delirium (another definition)

4

Symptoms become worse in late afternoon and evening

Sundowning

5

Some predisposing factors to delirium?

-Systemic infections
-Febrile illness
-Metabolic disorders
-Hepatic encephalopathy
-Head trauma
-Seizure
-Migraines
-Brain abscess
-Stroke
-Electrolyte imbalance

6

What are some meds to treat delirium?

-Benzo for substance withdrawal
-Antipsychotics (neuroleptics) for agitation, aggression, hallucinations, and illusions

7

What are some issues that could cause delirium?

Managing:
-Illnesses that can cause delirium
-Fluid and electrolyte
-Hypoxia
-Blood disorder
-Nutrition

8

Nursing process of delirium: look for the cause. What could be the cause of delirium?

UTI
Substance use
Withdrawal

9

A syndrome of chronic and possibly progressive intellectual and functional impairment involving memory, language, emotion, cognition, and changes in personality

Neurocognitive disorder

10

How does the DSM-5 classify neurocognitive disorders?

Mild or major
Primary (organic) or secondary (another disease causes it)

11

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

12

Can NCD be due to Alzheimer's?

Yes, this would be classified as primary (organic)

13

NCD: Assessment
what do we look for with history?

Mood, personality changes, cognitive changes

*Cognitive changes can be judgement, reasoning, memory, LOC, etc

14

NCD: Assesment Screen for ?

Anxiety and depression

15

NCD: Assessment What lab work is done in assessment?

Blood and urine

16

NCD: Assessment Why do we do a PET scan?

Reveal metabolic activity of the brain

17

NCD: Assessment Why do we do CT or MRI of brain?

View brain structures

18

NCD: Assessment Why do we do EEG?

Measure and record brain electrical activity

19

NCD: Assessment
Why do we do lumbar puncture for spinal fluid

Screen for infection or hemorrhage or CSF pressure

20

NCD: Diagnosis
What are risks for trauma?

Falls, wandering, confusion, poor coordination

21

NCD: Diagnosis
What happens if the patient has "disturbed/altered thought process"

Disorientation, confusion, memory deficits, paranoria

22

NCD: Diagnosis
What may the patient have if the patient has "disturbed sensory perception"

Experiencing hallucinations

23

NCD: Diagnosis
What if the pt. is aggressive, what is the risk?

Risk for other directed violence

24

NCD: Diagnosis
What is the patients diagnosis if they have aphasia?

Impaired verbal communication

25

NCD: Diagnosis
What if the patient has a self care deficit. What does this mean?

Inability to do ADLs

26

NCD: Diagnosis
What if the patient has the diagnosis of situational low self esteem or grieving. What may they be expressing?

Shame and social isolation

27

NCD: Implementation
What is the first and foremost thing to do?

Ensure safety

28

NCD: Implementation
Nursing care is directed to protect the client from ____ as well as promoting client ___ & ____; family education and support, and home safety

Injury;
Promoting client SELF ESTEEM AND LIFE QUALITY

29

NCD meds: What are the 3 cholinesterase inhibitors

Donepezil
Rivastigmine
Galantamine

30

NCD meds: What is the NMDA receptor agonist?

Memantine

31

NCD meds: What are the 4 antipsychotics?

Risperidone
Olanzapine
Quetiapine
Haloperidol

32

NCD meds: What are the 2 SSRIs?

Sertaraline
Paroxetine

33

NCD meds: What is the TCA?

Nortriptyline

34

NCD meds: What are the 3 Benzos?

Lorazepam
Oxazepam
Temazepam

35

NCD meds: What are the 4 selective hypnotic?

Zolpidem
Zaleplon
Eszopicline
Ramelteon

36

NCD meds: What is the antidepressant?

Trazodone

37

NCD meds: What is the TETRAcyclic antidepressant?

Mirtazapine

38

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

Aphasia

39

NCD effect: The inability to carry out motor activities and eventually unable care for self

Apraxia

40

NCD effect: The inability to recognize familiar objects

Agnosia

41

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

Executive functions

42

NCD effect: Creating imaginary events to fill memory gaps to cover up/deny that memory problem exists

Confabulation

43

NCD effect: Persistently repeating the same word or idea in response to different questions

Perseveration

44

NCD effect phenomenon where symptoms of NCD worsen at sunset/evening

Sundowning

45

NCD: What are some ways sundowning is managed?

-Control pain
-Reduce stimulation
-Turn on lights to minimize shadows
-Do quiet activity to distract
-No caffeine in afternoon or evening
-No alcohol drinks

46

What is another name for depression?

Pseudodmentia

47

Pseudodementia: Depression mimics the _____ noticed with a NCD

Cognitive changes

48

Is pseudodementa more rapid or slow than NCD?

Rapid onset

49

Do pseudodementa patients experience confabulate?

No, that is what happens in NCD---Pseudodementa experience FORGETFULNESS

50

Are pseudodementa patients oriented to time and place?

Yes

51

How is the pseudodementa patients performance?

Variable (with nCD it is a consistently poor performance)

52

Pseudodementia patients get ____ as day progresses

Better

53

NCD patients get ____ as day progresses

Worse

54

How is the appetite of pseudodemetia?

Poor

55

How is the appetite of NCD?

Unchanged appetite, but does not remember to eat

56

How is the concentration of pseudodementia?

Concentration intact

57

How is the concentration of a patient with NCD?

Impaired