ANXIETY
*increased awareness, alertness
*Learning enhanced
Mild Anxiety
Second most common type of dementia, abnormal proteins interfere with cell function of brain
*Rapid Progression*
Lewy Body Dementia
Excessive anxiety or worry about numerous things lasting for 6 months or longer
Generalized Anxiety Disorder
*establish trust
*advise exercise
*identify triggers
*use clear and factual knowledge
*administer and monitor medicine
Nursing Interventions for Anxiety
An abnormal fear of open or public places
Agoraphobia
Level of anxiety feeling something is definitely wrong person becomes nervous or agitated
*decreased alertness/attention span
*increased HR/RR
Moderate Anxiety
Stage of Dementia that interferes with working ability, may get lost when driving, decreased ability to plan organize
Stage 3 of Dementia
Physical symptoms w/o cause
Anxiety about symptoms
Seeking multiple providers
Symptoms are real to patient
Somatic Symptom Disorder
Reassurance of safety
Decrease maladaptive symptoms
Assisting with development of adaptive coping skills
Protect from self-harm
Nursing interventions for PTSD
PET B12
CT LFT/CBC/CMP/RPR
EEG UA
ECG CXR/Head X-Ray
HIB
Diagnostics For Neurocognitive Disorders
Level of anxiety survival skill take over, defensive responses ensue and cognitive skills decrease
*unable to problem solve
Severe Anxiety
Stage of Dementia forgetting events, inability to shop, handle finances, deny problems, may need assistance with safety.
*Confabulation*
Stage 4 Dementia
Conversion Disorder
Protect client from injury
Promote dignity and quality of life
Decrease stimuli
Allow time to complete tasks
Constant caregivers
Step-by-step instructions
Display clocks/calendars big print
Nursing interventions for dementia pateints
Increased risk of death in elderly
Level of anxiety unable to focus, unable to comprehend, may become violent
Panic
Stage of Dementia inability to perform ADL's, forget address, numbers, names, and easily frustrated
Stage 5 Dementia
2 Types of factitious disorders
Munchausen Syndrome - Patient repeatedly makes up clinically convincing simulations of disease for medical attention
Munchausen by Proxy- Parents make up or produce illnesses in their children
Acetylcholinesterase (Aricept, Exelon, Reminyl)
Medications for Dementia
Sadness without evidence of psychotic symptoms
Depressed more days than not for at least 2 years
Persistent Depressive Disorder
A level of Panic that can last 4-6 weeks
Crisis
Stage of Dementia with severe cognitive decline, can not speak in full sentences, difficulty following 2 step commands,
*Wandering/Sundowning*
Stage 6 Dementia
Repeated upsetting memories of the event, nightmares
Lack of interest in normal activities
Avoiding places, people or thoughts
Difficulty concentrating
Agitation / insomnia
PTSD
When should nurse expect client to show relief from antidepressants
1-4 weeks
Norepinephrine
Serotonin
Dopamine
Neurotransmitters in Depressive Disorder