Signs/Symptoms
Define Delirium
acute or sudden disturbance in attention, awareness, and cognition that develops in a few hours or days
Postmortem finding of clumps of protein on spinal cord and cortex
Lewy body dementia
Blocks break down of ACh
- Donepezil
- Rivastigmine
lock doors, put hazards away, clear path for walking in home, bed in lowest position, night light (if needed), fall risk, wander guard in place
Alzheimer's, Dementia, Delirium safety interventions
Role of a nurse for sundowning pt?
- remain calm
- create calm envirnoment
- maximize exposure to light
- limit naps/caffeine
- consult HCP on drug therapy
Define Dementia
a decline in cognitive function, a change in:
- attention
- executive function
- learning/memory
- perception
- social cognition
Genetic link, rapid disease course, onset before age 60
Familial dementia
Blocks NMDA receptors from making more proteins
Memantine: blocks further Amyloid beta growth
No cognitive impairment, changes are unnoticeable to others, but noticeable to family, which stage of Alzheimer's Disease is this?
Stage 1
Role of nurse in pain management ?
- choose appropriate pain scale for assessment
- monitor pt response
- realize will have difficulty communicating complaints
- may exhibit changes in behavior
Define Alzheimer's
chronic, progressive, irreversible neurodegenerative brain disease
forget important information that would have easily recalled; person is aware of change in memory
amnestic MCI (mild cognitive impairment)
Take with food, could cause life threatening issue of Hepatotoxicity, Stevens-Johnson Syndrome, and dysrhythmias
Rivastigmine
Bedridden, total care needed, nonverbal, which stage of Alzheimer's disease is this?
Stage 4
- assessing chewing and swallowing problems
- providing oral care in late stages
- providing easy grip utensils, finger foods
- assessing for under-nutrition problems
Vascular Dementia
abrupt onset, caused by single infarct or multiple infarcts
- poor prognosis
Hepatotoxicity signs/symptoms
- jaundice
- RUQ pain
- NV
- dark urine/dark stool
- pruritus
May cause Stevens-Johnson syndrome, NMS, and renal failure
Memantine
Health Promotion to reduce risk of Alzheimer's disease
- avoid harmful substances
- challenge your mind
- stay socially active
- avoid trauma to the brain
- high quality sleep
Role of a nurse for Alzheimer's related to skin care?
- assessing nutrition
- assessing incontinence
- assessing immobility
- identify and treat rashes and area of redness
Dementia with Lewy bodies
Presence of Lewy bodies (clumps of protein) in brainstem and cortex
metabolic, medication, medical event, or infection are contributing factors to this
delirium
NMS symptoms
Neuroleptic Malignant Syndrome
- high fever 102-104F
- autonomic dysfunction (high BP, high HR, diaphoresis)
- Rigidity
- change in mental status (confusion, delirium, altered LOC)
Alzheimer's behavior problems
repetitiveness, delusions, hallucinations, agitation, aggression
Role of nurse for alzheimer's pt with elimination problems?
- assessing for constipation
- moderate/severe stage urinary/fecal incontinence lead to behavior changes
- advocate for bowel regiment meds and scheduled toileting