1
A specific type of agitation and confusion that occurs in the late afternoon is called ____________________
Sundowning
What is "cogwheel rigidity" and what disease is it a characteristic of?
A jerky resistance to passive motion. Characteristic of Parkinson's.
What types of things in the hospital put people at risk for sensory overload?
Alarms, nurses and other staff in and out, TV's, people in the hallways. etc.
How do cataracts affect a patient's vision?
Blurriness and light sensitivity
What is the difference between conductive and sensorineural hearing loss?
Conductive = outer or middle ear problems impair transmission of sound waves into inner ear (ex: cerumen, otitis media)
Sensorineural = damage in the inner ear or the vestibulocochlear nerve (CN VIII)
What type of vision alteration would you expect in someone who has macular degeneration?
Blurring of reading matter, loss of central vision, distortion of vertical lines
What is the pathophysiology of Parkinson's?
Degeneration of dopamine-producing neurons in the brain. An inappropriate balance of Dopamine and Acetylcholine leads to disturbed movement (tremors, rigidity). Unusual clumps of protein called Lewy bodies build up, causing dementia.
What is the pathophysiology of glaucoma?
damage to the optic nerve due to high intraocular pressure
What is the pathophysiology of Alzheimer's?
Changes in the brain's structure and function involving: amyloid plaques, neurofibrillary tangles, loss of connections between neurons, and neuron death
What is the pathophysiology of Rheumatoid Arthritis?
Name 3 signs a patient might have a hearing deficit.
blank looks, decreased attention span, lack of reaction to loud noises, increased volume of speech, positioning of head toward sound, smiling and nodding, use of lipreading
change in appetite, excessive use of seasoning and sugar, weight changes
What are 3 things you should tell someone with diabetic neuropathy to do to protect their feet?
-wear well-fitting shoes
-wash feet and apply lotion, but make sure you let them dry completely
-inspect your feet frequently. use a mirror if needed
What are 3 things you should do before making an occupied bed to protect yourself and your patient.
-make sure the bed is locked
-raise it to a working height
-raise the siderail on the opposite side of you
Name 3 signs a patient might have a vision deficit.
squinting, falls, poor coordination, underreaching or overreaching for objects
Name 4 early warning signs of Alzheimer's
forgetfulness, difficulty doing familiar tasks (cooking, etc), decreased judgment (dress inappropriately), problems with word finding, misplacing things, changes in mood, changes in personality, loss of initiative (p. 1579)
Name 4 characteristics of the late or severe stage of Alzheimers
Problems eating/swallowing, unable to walk, incontinence, unable to talk, unable to understand words
Name 4 things people can do to decrease their risk for cognitive decline
avoid alcohol and drugs, challenge your mind, exercise regularly, stay socially active, avoid brain injury, maintain good blood sugar and blood pressure, get enough sleep, healthy diet low in fats and sugary foods
Name 4 things patients with Rheumatoid Arthritis can do to relieve joint pain and stiffness
Rest when needed, change positions often but avoid repetitive movements, protect joints from stress (use carts to move things, etc), cold packs to help with pain, moist heat to help with stiffness (warm showers/baths), gentle ROM exercises daily, eat a balanced diet
Name 4 things the nurse should teach a patient when being discharged after an eye surgery
-Signs and symptoms of infection
-restrictions for bending and coughing to prevent increased IOP
-how to instill prescribed eye drops (aseptic technique)
-safety precautions to prevent falls
Name 5 home accommodations you would recommend for someone who has impaired vision.
-grab bars and safety strips or non-skid mats in bathrooms
-remove clutter
- maintain good lighting
-make sure stairs have handrails
-make sure floors are level
-Remove throw rugs and extension cords
-have family members paint the edge of steps (especially first and last) bright yellow
Name 5 signs that would indicate a patient might have Parkinson's.
-Tremor
-Rigid muscles
-Cogwheeling rigidity
-Stooped posture
-Short, shuffling gait
-Postural instability (unable to stop themselves from going forward or backward)
-Bradykinesia (slowness of movement)
Name 5 things you should NOT do when communicating with someone who has Alzheimer's.
-Criticize, correct, or argue
-rush or hurry the patient
-force participation in activities or events
-talk about them as if they are not there
-take challenging behaviors personally. Blame the disease, not the patient.
-Use condescending terms, such as "honey" or "sweetie"
-Use threatening gestures (pg 1587)
Name 5 things you SHOULD do in communicating with and planning care for someone with Alzheimer's
-simplify tasks. focus on one thing at a time.
-utilize a structured, predictable daily routine
-use distraction, change the subject, redirect to other activities
-Prioritize safety. Lock doors and make sure things that may be ingested are out of reach.
-Offer liquids frequently and assist with feeding. You may have to remind them to chew and swallow (pg 1587)
Name 5 differences between Rheumatoid Arthritis and Osteoarthritis
RA autoimmune, OA wear and tear
RA systemic, OA local
RA young to middle age onset, OA usually older than 40
RA lost or maintained weight, OA often overweight
RA stiffness lasting > 1 hr, OA usually subsides after 30 mins
RA nodules common, OA nodules rare