Test 2: Blueprint (1)

Question 1

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

Answer 1

delirium

Question 2

Is delirium acute or chronic?

Answer 2

acute

Question 3

What is meant by “sundowning”?

Answer 3

symptoms become worse in late afternoon and evening

ex/ pts will wander around

Question 4

What are some predisposing factors of delirium?

Answer 4

• systemic infections
• febrile illness
• metabolic disorders (hypoxia, hypercarbia, hypoglycemia)
• hepatic encephalopathy
• head trauma
• seizures
• migraines
• brain abscess
• stroke
• postoperative states
• electrolyte imbalance

Question 5

How should delirium be managed?

Answer 5

1) determine and correct the cause

2) Medications

Question 6

What meds are commonly used to relieve delirium symptoms?

Answer 6

• benzos for substance withdrawal

- neuroleptics (antipsychotics) for agitation, aggression, hallucinations, illusions

Question 7

What is a syndrome of chronic and possibly progressive intellectual and functional impairment involving memory, language, emotion, cognition, and changes in the personality?.

Answer 7

neurocognitive disorder

Question 8

Is neurocognitive disorder associated with alzheimer’s primary or secondary?

Answer 8

Primary

Question 9

Is neurocognitive disorder associated with HIV, depression, or nutritional deficiency primary or secondary.

Answer 9

Secondary

These things CAUSE NCD.

Question 10

How is neurocognitive disorder assessed?

Answer 10

• History
• Physical and cognitive assessments
• Blood and urine lab work
• Chest x-ray
• PET, CT, or MRI of brain
• EEG
• Lumbar puncture

Question 11

What are 7 common nursing diagnoses associated with NCD?

Answer 11

1) Risk for trauma
2) Disturbed/altered thought processes
3) Disturbed sensory perception
4) Risk for other directed violence
5) Impaired verbal communication
6) Self-care deficit
7) Situational low self-esteem or grieving

Question 12

Name the nursing diagnosis:

Falls, wandering, confusion, poor coordination

Answer 12

Risk for trauma

Question 13

Name the nursing diagnosis:

Disorientation, confusion, memory deficits, paranoia

Answer 13

Disturbed/altered thought processes

Question 14

Name the nursing diagnosis:

Experiencing hallucinations

Answer 14

Disturbed sensory perception

Question 15

Name the nursing diagnosis:

Aggressiveness

Answer 15

Risk for other directed violence

Question 16

Name the nursing diagnosis:

Aphasia

Answer 16

Impaired verbal communication

Question 17

Name the nursing diagnosis:

Inability to do ADLs

Answer 17

Self-care deficit

Question 18

Name the nursing diagnosis:

Expressions of shame, social isolation

Answer 18

Situational low self-esteem or grieving

Question 19

What is the most important intervention for someone with a NCD?

Answer 19

SAFETY!!!

Question 20

What are common interventions with NCD?

Answer 20

1) Safety first and foremost!
2) Promote client self-esteem and life quality
3) Family education and support
4) Community referrals
5) Encourage and allow time to do ADLs, assisting as needed

Question 21

What classes of meds are used to treat NCD?

Answer 21

• cholinisterase inhibitors
• NMDA receptor agonists
• antipsychotics
• SSRIs
• TCAs
• Benzoa
• Selective-hypnotics
• Antidepressants
• Tetracyclic antidepressants

Question 22

Cholinisterase Inhibitor meds:

Answer 22

donepezil (Aricept)
rivastigmine
galantamine

Question 23

NMDA Receptor Agonist meds:

Answer 23

memantine (Namenda)

Question 24

Antipsychotic meds:

Answer 24

risperidone
olanzapine
quetiapine
haloperidol

Question 25

SSRI meds:

Answer 25

sertraline | paroxetine

Question 26

TRIcyclic Antidepressant (TCA) meds:

Answer 26

nortriptyline

Question 27

Benzodiazepine meds:

Answer 27

lorazepam oxazepam temazepam

Question 28

Selective-Hypnotic meds:

Answer 28

zolpidem zaleplon eszopicline ramelteon

Question 29

Antidepressant meds:

Answer 29

trazodone

Question 30

TETRAcyclic Antidepressant med:

Answer 30

mirtazapine

Question 31

Define aphasia:

Answer 31

- inability to speak or unable to express what they need | - forget meanings of word and names or use of things

Question 32

Define apraxia:

Answer 32

(apraxia sounds like TAXI...MOTOR) | the inability to carry out motor activities and eventually unable to care for self

Question 33

Define agnosia:

Answer 33

the inability to recognize familiar objects

Question 34

Define executive functions:

Answer 34

- coordinated in the frontal lobe - planning and organizing - remembering details - curbing inappropriate speech/behavior - integrating past experiences with past action - managing time for tasks

Question 35

Define confabulation:

Answer 35

creating imaginary events to fill memory gaps to cover up/deny that memory problems exist

Question 36

Define perseveration:

Answer 36

persistently repeating the same word or idea in response to different questions

Question 37

How can we manage sundowning?

Answer 37

- controlling pain - reducing stimulation - turn on lights to minimize shadows - distract with quiet simple activity - daily physical activity - short naps, not close to bedtime - reduce caffeine - not many (tiring) activities during the day