Mechanisms for managing stress and cognitive changes
what are 3 nursing interventions to prevent wandering?
bed alarm, chair alarm, supervised walks, locked units, telesitter camera, sitter, dementia fidget blankets
Which class of drugs is most commonly prescribed for depression?
SSRI's
sertraline, citalopram, escitalopram
which screening tool is most appropriate for identifying depression in older adults? the gold standard?
GDS Geriatric Depression Scale.
The GDS focuses on questions that reflect the common symptoms of depression in older adults, such as mood changes, energy levels, and sleep patterns
for delirium, this nursing priority is the most important to ensure patient safety
Fall Prevention
what is psychosis?
Disturbance in thought processes affecting cognition
How do fear, discomfort, and unfamiliar surroundings contribute to the development of behavioral symptoms in older adults?
Fear and discomfort can increase anxiety, agitation, and confusion, leading to behavioral symptoms. Unfamiliar surroundings may cause disorientation or distress, especially if the individual has cognitive impairment
Why should benzodiazepines be avoided or used with caution in the older adult population with confusion?
they can increase fall risk and worsen delirium. Causing sedation, resp distress., impaired coordination.
What is dyskinesia?
uncontrolled involuntary muscle movements
polypharmarcy increases risk of this acute condition?
older adults who recently had surgery or are hospitalized are at high risk for this
What are some common environmental stressors that can exacerbate symptoms in older adults with cognitive impairment, and how can nurses mitigate them?
Common stressors include noise, overcrowding, changes in routine, and poor lighting. Nurses can mitigate these by creating a quiet, well-lit, familiar, and structured environment that minimizes unnecessary disruptions
what medication is used for Parkinson's?
LEVODOPA. first-line medication is effective in reducing bradykinesia and rigidity. Carbidopa is usually added to minimize side effects and reduce peripheral breakdown of the levodopa.
what is Akinesia ?
inability to initiate movement
this 30-item screening tool is used for dementia and cognitive decline
Mini-Mental State Exam (MMSE)
what are 2 modifiable risk factors?
Physical inactivity, Unhealthy eating, Lack of cognitive stimulation, Social isolation, Poor control of chronic conditions, especially cardiovascular disease and diabetes
what are 2 communication techniques to support individuals with cognitive impairment?
Nurses can use clear, simple language, avoid distractions, maintain eye contact, speak slowly, and use non-verbal cues like gestures. It's important to be patient and allow the person time to respond
The most common side effects of the CIs are nausea and diarrhea. But can lead to a cholinergic crisis with an acronym known as SLUDGE. define SLUDGE
•S: Salivation
•L: Lacrimation - tears
•U: Urination
•D: Diaphoresis
•G: Gastrointestinal upset – nausea/diarrhea
•E: Emesis
What is CAM assessment used for?
used to detect delirium in people at risk for dementia. A positive score indicates that there is a presence of acute onset or fluctuating course and inattention, and either disorganize thinking or altered LOC.
what are 3 common causes of delrium?
infections (UTI,PNA), medications, dehydration, uncontrolled pain, and hospitalization.
what are 2 non-modifiable risk factors?
Advancing age (34.6% aged 85+), Genetics and family history (African Americans and increased risk with APOE-4), History of traumatic brain injury, Down syndrome
Onset for Delirium, depression, and dementia?
Delirium: sudden, abrupt. Depression: recent, may relate to life change, can be chronic. Dementia: slow, over years and often unrecognized until deficits are obvious.
What drug class is Memantine and what is it used for?
NMDA receptor antagonist that helps slow progression of moderate to severe Alzheimer's Dementia
NMDA short for N-methyl-D-aspartate
this brief test with 5 items is often used for dementia screening in primary care
Mini-Cog
Aphasia, apraxia, and agnosia are hallmark symptoms of which progressive disease?
Alzheimer's Dementia