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nurs 211
impaired cognition: dementia, delerium,
| Question | Answer |
|---|---|
| Classification of Aging: what is older; elderly; aged; very old | 55-64; 65-74; 75-84; 85 and older |
| when aging what causes the most frequent limitation on adls | musculoskeletal |
| psych changes with aging: memory function- short or long term deteriation with age; what ppl have less memory decline; | short; well educated mentally active ppl; |
| psych changes with aging: intellectual functioning- does socialization abilities decline; what skills decline | socialization abilities; problem solving skilss |
| psych changes with aging: learning ability- ability to learn increases or decreases with age; they need greater time for what | does not decrease with age but score lower on performance tests requiring rapid response; learning |
| adaptation to the tasks of aging: they are predisposed to what bc of loss; grief from loss can cause ___ overload; | depression; bereavement |
| adaptation to the tasks of aging:what contributes the the well being of the elder; what becomes more stable in elderly over time; good psychosocial factors affecting adjustment later in life are what | social networks; self identity; sustained family relationships, maturity of ego relationships, absence of alcoholism, absence of depressive disorder |
| adaptation to the tasks of aging: what is a myth among the elderly; what are dying persons fears; what does someone most desire when dying | death anxiety; abandonment, pain and confusion; someone to talk to |
| theories of aging: developmental task theory- erikson described the primary task of old age as what; if elder does not meet integrity what feelings dothey have | being able to see one's life as having lived with integrity; despair |
| theories of aging: disengagement theory- this is the process of withdrawal by older adults from what; | social roles and responsibilities; |
| theories of aging: activity theory- opposite of what theory; belief that the way to age is to be ___; | disengagement theory; active; |
| theories of aging: continuity theory- the person's previously established ____ is basis for predicting adjustment to the changes in aging; ex | coping abilities; a person who enjoys social activities will continue over a lifetime or a person wno enjoyed a solitude and limited activities will continue the same |
| dementia: what is the onset; what is the course of impairment; what age | insidious; gradual progressive course of cognitive impairment; 65 and older and very common in 85 and older |
| dementia: what type of memory loss; along with the memory loss what other cognitive defects are there; | short and long term; aphasia, apraxia, agnosia, disturbed executive function |
| def aphasia | language problems |
| def apraxia | organization problems |
| def agnosia | unable to recognize an object or tell their purpose |
| def disturbed executive function | personality and inhibition |
| classifications of dementia: primary dementia- the dementia is a major sign of what disease; is it r/t any other organic illness; ex; what happens in this | organic brain disease; no; Alzheimer's; diminished brain metabolic activity and brain atrophy |
| classifications of dementia: secondary dementia- caused by what; ex | another disease or condition; HIV, head trauma, Parkinson's, Huntington's, substances, CVA |
| classifications of dementia: reversible dementia- common; can dementia be determined reversible often; what can be done; ex | very small % of ppl; no; determined by underlying pathology and early tx; cerebral legions, depression, medication side effects, hydrocephalus, vit or nutritional deficiencies, CNS infections and metabolic disorders |
| symptoms of dementia: what is behavior; what is neglected; is language effected; difficulty naming objects is r/t what; | uninhibited and inappropriate; personal hygiene and appearance; maybe; aphasia; |
| symptoms of dementia: what change is common; as disease progresses what happens to motor activities; so that is the motor functions | personality changes; inability to carry out them (apraxia); apraxia |
| symptoms of dementia: they wander where; impairment in what; | away from home; abstract thinking, judgment, impulse control |
| stages of dementia: stage 1: what are the s/s | no s/s |
| stages of dementia: stage 2: what are s/s | forgetfullness |
| stages of dementia: stage 3: there is a mild decline in what; the dcline interferes in what; ex of this stage | cognition; work performance; gets lost when driving, difficulty recalling names, decline in ability to plan or organize |
| stages of dementia: stage 4: what continues to decline; there is more pernounced ___; ex | mod cognition decline; confusion; forgets major events in personal hx, unable to perform tasks such as shopping, unable to understand news events |
| stages of dementia: stage 5: this is termed what type of dementia; ex | early; loss of ability to perform, adls independently, forget address, names ofclase relatives, disoriented to place and time, frusteration and self absorption are common |
| stages of dementia: stage 6: what is the cognitive decline; this is what type of dementia; ex; what happens to body functions | mod to severe decline; middle; unable to recall recent major life events, forget spouse's name, disorientated to surroundings iscommon, unable to manage ADLS without assist; incontinence |
| stages of dementia: stage 6: what are psychomotor s/s; what is a common s/s; loss of what skills happen | wandering, obsessiveness, agitation and aggression; sundowning; language skills |
| stages of dementia: stage 7: what is cognitive decline; what is the type of dementia; they cannot recognize what; ex of issues | severe; late; family members; immobility, decreased immune system, decreased appetite, speech and language severely impaired |
| sundowning: this causes an altered what; def; | thought process; increased confusion late in the afternoon evening r/t fatigue, lack of sensory stimuli, or biological needs |
| sundowning: interventions | routine nap after lunch, involve in favorite activity, use nightlights or TV, allow to get up and walk around, safe activities, don't restrain, assess for pain |
| why should it be dx; | to find treatable conditions, find treatable s/s, identify caregivers |
| vascular dementia: cause; how common is this type; what deteriation occurs; prognosis worse or better then alzheimers; what happens | significant cerebrovascular disease;2nd most common type; intellectual; worse; blood vessels of the brain are affected, interrupted flow and progressive intellectual deterioration occurs |
| vascular dementia: more or less abrupt then alzheimers; cause from mini ___; progress of s/s occurs in steps or gradual declines; can it improve sometimes; the pattern of decline is regular or irregular | more; strokes; steps; yes; irregular |
| vascular dementia: what is cause of strokes; tx | HTN, emboli; manage cardio/cerebrovascular disease, control HTN, DM |
| Alzheimers: characterized as the syndrome of s/s identified as ___ in the DSM; how many stages; | dementia; 7; |
| what is the most common form | alzheimers |
| Alzheimers: what is onset like; what is the crouse of disorder; when do first s/s usually occur | slow and insidious; progressive and deteriorating; before 65yo; |
| Alzheimers: what are early s/s; when does late onset occur; what are the the s/s of late onset | behavioral disturbances like wandering and agitation; > 65 yo; behavioral disturbances with wandering and agitation; |
| s/s unique to Alzheimers: they have what 2 things; | unique delusions and visual hallusinations |
| s/s unique to Alzheimers: imposter syndrome- def; akal | one's house is not home or family abandoned them; capgras syndrome |
| s/s unique to Alzheimers: phantom border- this is the belief that someone is uninvited and living where; | in the affected individuals home - typically in the attic or upper floorw |
| s/s unique to Alzheimers: tend to think what about their own children; the believe what about their spouse | that they are babies; that the are unfaithful |
| s/s unique to Alzheimers: what is the name for the visual hallucinations; what do the hallucinations consist of; what are risk factors; | Charles bonnet syndrome; well defined organized and clear images over which the subject has little control of; |
| Charles bonnet syndrome: risk factors; what is cause | bilateral visual system impairment, declining visual acuity, cognitive deficits, stroke, and alzheimers disease; changes in the visual system may alterreceptive fields in the visual cortex and lead to spontaneous neuronal discharge and phantom vision |
| Alzheimers: how can acetylcholine alteration cause this; when acetylcholine is reduced this reduces the amount of what; less neurotransmission = what; | the enzyme required to produce acetylcholine is dramatically reduces in the brain; neurotransmitters; decreased cognitive processes; |
| Alzheimers: are genetics a cause; what other preventable cause | yes; head trauma |
| Alzheimers: therapies- why is exercise used; eating more ____ can slow rate ofcognitive decline ; what vit should be in diet; prevent and control what diseases | to increase brain circulation; veggies; E and C; DM, hyperlipidemia, HTN, heart disease |
| dementia screening: what is done; why are dx tests done; what dx tests are done; | physical exam, mini mental, dx tests; to rule out anything abnormal; CBC< met profile, HIV< RPR,TSH, B12,CT, MRI, PET |
| dementia screening: what does FDDNP pet scan do; | the FDDNP molecule binds to tangles and plaques in brain |
| dementia screening: is there curative tx | no |
| dementia symptomatic tx what are they | meds, attention to the environment, family support can enhance level of functioning |
| caregiver support: caregivers who received 6 months of intensive help with care giving strategies were better how; what are caregiver strategies; | they had significant improvements in overall quality of life, had lower rates of clinical depression; information sharing, instruction, role play, problem solving, skills training, stress management techniques, telephone support groups; |
| what is reach | resource for enhancing Alzheimer caregivers health |
| meds for dementia: cholinesterase inhibitors- name them; what are side effects; effect | Aricept, Exelon, razadyne; nausea, diarrhea; boost the levels of a chemical messenger involved in the memory and judgement |
| meds for dementia: NMDA receptor antagonists- name them; side effects; effect; what med can it be combined with | memantine (Namenda); increase BP; reduces high levelsofglutamate in the brain,slows neuronal degradation and progression of the disease; cholinesterase inhibitors |
| delirium: characterized by a disturbanceof what; there is a change in what; | consciousness; cognition; |
| def ofcognition | the mental process of knowing, including aspects such as awareness, perception,reasoning,and judgment |
| delirium: rapid or slow onset; duration is long or brief | rapid; brief |
| delirium: how long does it last; how is it reversible; | not more then a month; with correction of underlying determinants; |
| delirium: s/s- they have difficulty sustaining and shifting ____; how is focus; how is thinking; what is speech; what is reasoning; | attention; difficult; disorgansized; rambling, irrelevant, pressured and incoherent; impaired and no goal directed behavior |
| delirium: s/s- what is there LOC; what is issue short or long term memory | disoriented to time and place; short |
| delirium: what psych issues are common; what happens in dreams; state of awareness is affected by what; what happens in state of awarenessness; | illusions and hallucainations; vivid ones and nightmares; sleep; hypervigilance, hypersolmnolence, insomnia; |
| delirium: def hypervigilance; def hypersomnolence | heightened awareness to environmental stilmuli; excessive sleepiness |
| delirium: what is the psychomotor activity; what happens to emotions; | agitated, purposeless movements, vegetative state resembling catatonic stupor; they are instable |
| delirium: what are emotions; what are autonomic s/s | fear, anxiety, depression, irritability, anger, euphoria, apathy; tachycardia, sweating, flushed face, dilated pupils, and high BP |
| delirium due to a general medical condition: what can cause this | infections, metabolic disorders, fluid or lyte imbalance, hepatic or renal disease, thiamine def, head trauma, |
| what may cause thiamine def | ETOH abuse |
| substance induced delirium: how do meds cause this; name the meds; | the side effects; anesthetics, analgesics, psychotropics with anticholinergic effects, anticonvulsants, antihistamines, antihypertensives, lithium, GI meds, immunosuppresives, steroids |
| delirium: toxin exposure- what toxins can cause this | organophosphates, insecticides, carbon monoxide, volatile substances |
| delirium: suctance withdrawal- cause; when can it happen with withdrawal | reduction or termination of high dose ETOH, sedatives, hypnotics, anxiolytics; with in a few hours to 4 wks |
| delirium:what is the cause of it due to multiple etiologies | more then 1 general medical condition or combined medical substance use |
| amnestic disorder: what is attention span; how is learning; what memory deficits short or long term; they cannot recall what; what is most difficult to recall past or present info | normal; inability to learn new info; short and long; previously learned info; past |
| amnestic disorder: why do they engage in making stuff up; making stuff up is aka; | bc they cannot remember; |
| amnestic disorder: what is emotion; how does it differ from dementia; | bland; there is no impaired abstract thinking, no other disturbances of higher cortical function, no personality changes |
| amnestic disorder: what is onset; what is the duration; duration depends on what; | acute or insidious; variable; the severirty and cause of condition; |
| amnestic disorder: what are predisposing medical conditions; | head trauma, brain cancer, cerebral anoxia, herpes encephalitis, poorly controlled dm, brain surgery, cerebrovascular disease; |
| amnestic disorder: what is substance induced causes; | ETOH, sedatives, hyponotics, anxiolytics, meds and toxins; |
| amnestic disorder: how long to s/s last if they are transient; what does it mean is s/s are chronic; what could cause transient s/s | <1 month; they last >1 month; cerebrovascular disease, arrhythmias, migraine, thyroid disorders, and epilepsy; |
| amnestic disorder: assessment- what are specific cognitive changes; what happens with language; what might be found in he physical assessment | attention span, thinking process, problem solving, memory; there is difficulties; signs of damage to the nervous system |
| diagnotistcs for delirium or amnesia: what labs; what scans; | hepatic or renal functions, glucose, lytes, metabolic and endocrine, nutritional def, toxic substances; EEG, CT scan/MRI, lumbar puncture |
| goals for delirium or amnesia: not experience physical harm, not harm self or others, makeneeds known to caregivers, maintain orientation at optimum ability, complete ADLs with assist, maintain scheduled routine, maintain wt | |
| nursing dx for delirium or amnesia: why is there a risk for trauma; wandering is a means to handle what; interventions for wandering | rt wandering; stress; provide a safe environment; |
| Catastrophic reaction: what happens to client; s/s of this | they are overwhelmed; crying, pacing, restlessness, combative, critical |
| Catastrophic reaction: prevent what; limit what; don't take what personally | situation; decision making; reaction |
| nursing dx for delirium or amnesia: why is there a risk for injury; what is short term goal; what type of environement should there be; | r/t agitation and anger; wil not harm self or others; low stimuli; |
| agitation: refrain from what; never ask what; what type of voice; link bevaior to what; what type of touch; | restraints and reasoning; why; low warm voice; need; catious nurturing touch |
| altered thought process: r/t what; AEB what; what is goals; interventions | cerebral hypoxia, degeneration; confusion, disorientation, inaccurate interpretation of environment; will make needs known to caregivers; promote security, clocks and calenders, validate what is real, divert attention from what is not real, remove stresso |
| altered thought process r/t suspicion: this is viewed as a result of things beyond what; intervientions; | their control; keep duplicate items, help search and validate their concern, non-defensive reaction to accusations, no lectures or confrontations, approach from from |
| ineffective coping: evidenced by what; they are looking for what; interventions | hoarding behaviors; something familiar; store frequently used items in easy access, learn hiding places, make sure food is not spoiled, distract client if found where they do not belong |
| delirium: we should orient to what; what should environment be; | reality; low level of stimuli |
| reminiscence therapy: stimulation of life memories helps older adults to what; | work through their lossess and maintain self esteem; |
| validation therapy: for whom; accept whatever dementia pt claims as what; accept the values and beliefs as what | confused clients with mod to severe dementia; their reality; reality |
Created by:
jmkettel
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