| Question |
Answer |
| What is NOT considered a normal part of the aging process? |
Confusion |
| What is the most common psychiatric disorder found in the general medical hospital? |
Delirium |
| What is often seen in the hospitalized elderly patient aka ICU psychosis? |
Delirium |
| What are signs and symptoms of Delirium? |
Confusion, Insomnia/Day night reveresal, Restlessness-"picking" sheets, climbing out of bed, pulling on tubes, may experience hallucination, delusions, may cry and scream |
| What are the causes of Delirium? |
Dehydration, Infection, Electrolyte imbalance, head trauma, substane abuse intoxication, withdrawl, sleep deprivation, |
| What are the treatments of Delirium? |
Identify the causative stressor and correct it, reality orientation, verbally use of calanders, windows ect, maintain safety, provide consistent caregiver/enviroment when possible. |
| Why should you provide a consistent caregiver/ enviroment for a pt with Delirium? |
To decrease anxiey and confusion. |
| What is Cognitive impariments characterized by gradual onset and is progressive and permanent Judgement, memory, abstract thinking, and social behavior are affected. |
Dementia |
| What are major causes of Dementia? |
Alzheimer's disease (AD), Multi-infarcts(CVA's), Parkinson's disease (PD), multiple sclerosis (MS), Head injury |
| How is Alzhemimer's Disease diagnosised? |
Related to cognitive and behavior assessments, autopsy reporst verify diagnosis. |
| What happens in mild stage of Alzheimers disease? |
frequently repeating oneself, regularly misplacing objects, agnosia,Aphasia, Confabulation, Frustration, Anxiety & depression r/t forgetfulness and short term memory loss, family and friends often not aware of problems |
| Inability to recall familiar words used in conversation |
Aphasia |
| not considered lying ego protective |
confabulation |
| What are moderate signs and symptoms of Alzhiemer's disease? |
Decreased ability to perform ADLs(incontinent), "lost" in own house, disoriented to time or place, wandering or pacing, prone to accidents due to visual perception difficulties, apraxia, temperament fluctuations, sundowning, easily distracted, family awar |
| inability to perform motor tasks although motor function intact. can not zip or button |
Apraxia |
| symptoms are worse after sunset |
sundowning |
| What are the signs and symptoms of severe Alzhiemers? |
inability to care for self, lost use of language, almost complete loss of memory, requires care 24/7, almost always bedriddenor sits in a chair all day. |
| What are the treatments for Alxhiemers for cognition? |
Anticholinesterase(tacrine/Cognex) (Aricept/donepezil) usually used in mild to moderate AD, thought to prevent rapid decline in cognition, pt. should have weekly assessments of liver function |
| What treatment is used for Alzhiermer's for agitaion or psychosis? |
Antipsychotic (Risperdal/Risperidone |
| What are the nursing interventions for the pt with Alzeimers disease? |
maintain safety, reality orientation early in the disease process, consistent caregiver/enviroment, routines, use signs to direct pt, encourage simple task to build selfesteem, toilet q 2, distraction when irritable, memory book, be creative, caregiverstr |
| How is Vascular Dementia diagnosised? |
by MRI and CT scans |
| What are signs and symptoms of Vascular Dementia? |
similar to Alzheimers, more specifically related to area of infarcts. |
| What are some signs of Vascular Dementia that is unlike pts with AD? |
may have focal neurological signs, extremity weakness, abnormal reflexes, tingling in a limb, slurring of speech, weakness, and drooping of face |
| What are some nursing diagnosis related to delirium and dementia? |
Acute confusion r/t delirium and underlying (causative agent), Risk for Injury r/t impaired cognition(safety), Chronic Confusion r/t Alzheimers disease, Anticipatory Grieving r/t expected loss of cognitive function |
| Nursing Diagnosis cont. |
self care deficits r/t cognitive & motor impairments, Risk for caregiver role strain. |
