Module 10 - Impaired Cognition
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| What age is considered "older adulthood"? | 65 years to death
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| What is a fact of older adulthood? | More than half of adults over 65 years of age are living at home with a spouse or are maintaining a household alone
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| Physical aging process varies greatly and is affected by what? | Genetics, early physical health care, early mental health care, current lifestyle practices, and attitude
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| What is integrity? | State of wholeness
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| What is despair? | Not achieving a state of wholeness
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| An individual who has developed integrity, has done what? | Accepts the worth and uniqueness of his/her lifestyle
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| What is life filled with for older adults who have not reached a sense of wholeness? | Despair
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| What physical adaptations can prevent medical problems in older adults? | Aerobic and muscle strengthening
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| What does a sound physical body have a better chance of? | Housing a sound psychosocial "body"
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| What do older adults have problems related to? | Money, adequacy of food, housing, and health care
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| What mental health problems can arise when they worry about money? | Depression, anxiety, and paranoia
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| What types of problems occur with housing in the older adult? | Having "too much house" (to large to take care of) to having no housing at all
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| What often becomes a companion to an older adult after the death of a spouse or significant other? | Depression
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| Why are older adults at risk for substance abuse? | Metabolize and excrete drugs slowly
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| What may contribute to the misuse of medications? | Sight and memory; drug interactions are big risk (patient's see multiple physicians and use many different pharmacies)
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| What is the best way to refer to medications when teaching patients about medications? | Name and provide written instructions
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| What is elder abuse? | Any action that takes advantage of an older person or his/her emotional well-being or property
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| What is exploitation? | Improper use of a person for one's own profit
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| What is aging? | Process of growing older
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| What is gerontophobia? | Fear of aging and refusal to accept the mainstream of society
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| What is ageism? | Practice of stereotyping older persons as feeble, dependent, and nonproductive
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| What is crystalized intelligence? | Specialized accumulated knowledge (nursing, engineering, tech skills) that remain intact until 75 years or older; may remain intact until death
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| What is hoarding? | Act of collecting and saving assorted, seemingly useless items
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| What is functional assessment? | An analysis of the client's ability to perform the activities of daily living. The environment in which the client lives, as well as cultural & social patterns
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| What is memory loss? | Natural par of the aging process relating to the inability to recall certain details or events
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| What is confusion? | Mixed up, bewildered, or uncertain
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| What is delirium? | Change of consciousness that occurs quickly
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| What is dementia? | Loss of multiple abilities, including memory, language, and the ability to think and understand (judgment & abstract thought)
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| What are some causes of dementia? | Metabolic disorder, Electrical disorder, Neoplastic disease, Degenerative disease, Arterial disease, Mechanical disorder, Infectious disease, Nutritional disorder, Drug toxicity
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| What is Alzheimer's Disease? | Progressive, degenerative disorder that affects brain cells and results in impaired memory, thinking, and behavior
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| What is probably the most common mental health disorder of late adulthood? | Depression
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| What can nurses assess for that signal the onset of depression? | Behaviors
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| What are the different ways that depression can be treated? | Individual and group therapy, as well as medications
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| What are some physical signs & symptoms of depression? | Abdominal pain, nausea & vomiting, dry mouth, muscle aches, headaches
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| What are some cognitive (intellectual) signs & symptoms of depression? | Confusion, agitation, paranoia, focus on the past, thoughts of death and suicide, decreased memory
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| What are some emotional signs & symptoms of depression? | Fatigue, increased anxiety or dependence, feeling useless, hopeless, or helpless, lack of interest
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| What are some behavioral signs & symptoms of depression? | Difficulties with ADL, changes in appetite and/or sleeping patterns, low energy, poor grooming, withdrawal from people & activities
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| What are different types of individual or group therapy for depression? | Reminiscence or validation therapy
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| What is validation therapy? | Caregiver buys into client's illusions and plays along until an opportunity to refocus behaviors is present
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| What does cognition refer to? | Higher brain function: intelligence, learning, judgment, reasoning, knowledge, understanding, and memory
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| What is cognitive impairment? | A disruption in higher brain function that results in confusion
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| What are the most significant losses in cognition? | Slower response times and impaired short-term memory
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| Is confusion normal or not normal in older adulthood? | Not normal
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| What are the five D's of confusion? | Damage, Delirium, Dementia, Depression, and Deprivation
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| What is often the first sign of a drug reaction? | Confusion
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| What are the causes of dementia? | Primary (Alzheimer's disease) and secondary as result of disease such as HIV
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| What types of dementia are there? | Vascular dementia and Alzheimer's Disease
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| What are the two categories of AD? | Early onset (before age 65) and late onset
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| Is AD a normal part of aging? | No
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| What does AD involve? | Gradual, progressive death of one's brain and it's functions
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| What are the stages of AD? | Early, Intermediate, Severe, and End
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| What is the early stage of AD? | Loss of recent memory; inability to learn, process information, and retain information, and language problems
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| What is the intermediate stage of AD? | Inability to recall any recent events or process new information
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| What is the severe stage of AD? | Inability to do anything (patient requires total care)
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| What is the end stage of AD? | Leads to coma and death can occur
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| What are the three major goals for therapeutic interventions of AD? | Provide for clients safety and well being; manage client's behaviors therapeutically; and provide support for family, relatives, and caregivers
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| What do you do when a client with AD is behaving inappropriately? | Redirect to less stressful activity
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| What OTC medications are considered high alert drugs that may cause confusion? | Medications used to treat cold & flu, diarrhea, hay fever, and insomnia
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| What is sundowners syndrome? | Group of behaviors characterized by confusion, agitation, and disruptive actions that occur in the late afternoon or evening
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| What issues may contribute to sundowners syndrome? | Hunger, thirst, pain, need to eliminate, feelings of fear, insecurity, isolation, little contact with other people, recent move, and recent change is routine
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| What are therapeutic nursing interventions for sundowners syndrome? | Maintain comfort, toilet as necessary, keep dry, control pain, reduce environmental stimulation, maintain daily routine, provide soothing music, provide reassurance & companionship during evening hours
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| What are signs and symptoms of AD? | Memory loss, difficulty performing tasks, disorientation to time and place, changes in personality
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| What does memory loss as it relates to AD? | Short-term, forgets and never remembers, troubles with association
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| What does difficulty performing tasks as it relates to AD? | Forgets what order to put clothes on, prepares meal but then forgets to serve it, leaves the car running
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| What does disorientation to time and place as it relates to AD? | Gets lost on one's own street, forgets where he/she is or how he/she got there
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| What is changes in personality as it relates to AD? | May become angry, anxious, apathetic, depressed, fearful, irritable, suspicious, may become agitated in situations where memory problems are causing difficulties
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| What is affective loss? | Slow drain of one's personality; emotional control declines as the individual fades into childlike, antisocial, or emotionally labile behaviors
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| What is a nursing intervention for the early stage of AD? | Supervise and protect persons safety
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| What is a nursing intervention for the severe stage of AD? | Be attentive to needs that can no longer be expressed; arrange for nursing home care
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| What drugs can be used for treatment of AD? | Aricept (donepezil), Exelon (rivastigmine), Razagyne (galantamine), Namenda (memantine)
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| What are side effects to Aricept (donepezil)? | Nausea, vomiting, diarrhea, dizziness, headache, insomnia, high/low blood pressure
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| What are side effects to Exelon (rivastigmine)? | Tremors, confusion, insomnia, depression, anxiety, headache, sleepiness, fatigue, nausea, vomiting, anorexia, diarrhea, constipation, increased sweating, UTI, weight changes
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| What are side effects to Razadyne (galantamine)? | Anemia, slowed heart rate, blood in urine, nausea, vomiting, anorexia, gas, diarrhea, urinary incontinence, weight decrease
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| What are the nursing interventions for clients with AD? | Treat person not disease, treat as individual, establish & maintain commun., provide physical rest, care, & exercise, maintain safe & supportive environ., maintain routine & consistency, manage difficult behaviors w/o reacting
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| What are communication techniques for a person with AD? | Always approach from front, speak in normal tone of voice, face person as you talk, minimize hand movements, avoid setting w/increased levels sensory stimulation, use simple words & short sentences, ask yes/no questions, allow plenty of time for response
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| What are orienting environmental cues? | Keep environment safe and "user friendly", use ramps, grab bars, no throw rugs, use large signs to identify rooms, label drawers with large letters & simple words, use clocks & calendars, cover doors w/ curtains/posters to discourage wandering
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| What is life review therapy? | A systemic reflection of one's personal history in which one learns to evaluate, integrate, and accept life as it has been lived
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| What is audio presence intervention? | Playing of tape-recorded memories by family members to help decrease agitation
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| What accompanies the caregiver when caring for a client with AD at home? | Tremendous physical and emotional burdens; there are various sources of support help family members through this difficult journey
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