Degenerative Neurological Disorders - Parkinsons Vascular Dementia
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Dementia | show 🗑
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Aphasia | show 🗑
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Apraxia | show 🗑
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Agnosia | show 🗑
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show | single words, omits word such as 'the' 'of' 'and', wrong word order, makes up words. Receptive - needs more time to understand words, does not understand idioms/slang expressions
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show | Oral apraxia - is an inability to make voluntary, non-speech oral movements. Limb Apraxia - is a planning deficit that impairs the voluntary movements of the arms, hands, legs and feet
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show | Apraxia of gait - refers to difficulty with programming the motor movements involved in walking. Apraxia of the swallow - refers to a patients inability to swallow volitionally.
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show | inability to recognize objects, inability to recognize familiar people, inability to recognize a familiar sound, inability to recognize a familiar shape, inability to recognize a familiar smell
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Characteristics of Deficits in Executive Fcn | show 🗑
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Vascular Dementia/Multi-infarct | show 🗑
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S/S of Vascular Dementia | show 🗑
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show | Similar treatment for cardiovascular disease: Statins (Lovastating): decrease risk of atherosclerosis, anti-HTN, managing DM, acetylcholinesterase inhibitors - may slow disease progression
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ACIs - Acetylcholinesterase inhibitors | show 🗑
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show | NT which stimulates muscle tissue and is important for memory, thinking and reasoning - Dementia is associated with low levels of acetylcholine
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show | donepezil (aricept ) 10mg/day single dose, Galantamine (razadyne) 24mg/day in 2 divided doses, Rivastigmine (Exelon) 12 mg/day in 2 divided doses, Tacrine (cognex) 160 mg/day in 4 divded doses
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show | People with Parkinsons disease are 6x more likely to develop dementia
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show | MRI, CT, CAT, PET, EEG used to rule out other diseases. Cerebrospinal fluid may show a decrease in dopamine.
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show | CARDINAL S/S: muscle rigidity, akinesia, tremors, postural instability. autonomic deficits:orthostatic hypotension, difficulty chewing and swallowing
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treatment of Parkinson's related Dementia | show 🗑
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Levodopa Combined with Carbidopa | show 🗑
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show | A sudden state of severe confusion and rapid changes in brain fcn, sometimes associated with hallucinations and hyperactivity, in which the patient is inaccessible to normal contact.
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S/S the patient with delirium show | show 🗑
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Causes of reversible dementia/delirium | show 🗑
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show | Progressive nonreversible neurologic disorder, results in memory loss, personality changes, global cognitive dysfunction, and functional impairments
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show | age over 65, genetic disposition, environmental agents such as herpes virus, metal or toxic waste, poor cardiovascular helath, previous head trauma or injury
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show | characterized by extracellular deposition of amyloid-beta protein, intracellular neurofibrillary tangles, and loss of neurons; these are findings that can only be detected at autopsy. Severe decline occurs with deteriorating cognitive functions
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show | Gross, diffuse atrophy of the brain and loss of neurons, neuronal processes and synapses in the cerebral cortex and certain subcortical regions. Decreased level of neurotransmitters - Acetylcholine, Serotonin, Norepinephrine, and somatostatin.
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show | deceased energy/spontaneity, short term memory loss, decreased attention span, subtle personallity changes, mild cognitive deficits, difficulty with $, difficulty with depth perception
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Moderate S/S of AD (Alzheimer Disease) | show 🗑
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show | disoriented to time and place, disturbed sleep pattern, impaired motor skills, impaired communication skills, bowel and bladder incontinence, inability to recognize family and friends, language becomes severely disorganized and then is lost altogether,
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show | Rise slowly when standing
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show | rock back and forth to start each movement
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NCLEX: a patient is experiencing a parkinsons crisis. The nurse would immediately place the patient | show 🗑
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show | Encourage and praise perseverance in exercising and performing ADLs
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show | recommend family members bring pictures to the patient room
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NCLEX: an old woman was brought for evaluation due to the hospital for evaluation due to increasing forgetfulness and limitations in daily function. The daughter revealed that the client used her toothbrush to comb her hair. She is manifesting | show 🗑
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NCLEX: the primary nursing intervention in working with a ct with moderate stage dementia is ensuring that the client | show 🗑
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NCLEX:Dementia unlike delirium is characterized by | show 🗑
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NCLEX:A pt with delirium becomes agitated and confused in his room at night. The best initial intervention by the nurse is | show 🗑
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show | Dopamine Replace (Dopar - Levodopa)
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