Alzheimer's Disease
True/False:
A client with Alzheimer's Disease should be encouraged to maintain a routine and utilize calendars to help reduce disorientation.
True
Abrupt and reversible changes in mental state or cognition
Delirium
Symptoms of schizophrenia must last for ______ months to be diagnosed, according to DSM-5 diagnosing criteria.
Six (6) months
A 82-year-old client who is hospitalized for an urinary tract infection has become disoriented and confused 3 days after admission. What information indicates this patient is experiencing delirium rather than dementia?
a) The client is oriented to person but not time or place.
b) The client has a history of increasing confusion over the last several years.
c) The client was alert and oriented upon admission.
d) The client is from a memory care unit facility.
C - The client was alert and oriented upon admission.
List three (3) nursing interventions that provide cognitive stimulation for a client with dementia.
Use clocks/calendars to assist with orientation.
Maintain a routine.
Use short directions for skills or care.
Be consistent, repetetive.
Offer a variety of environmental stimulations (walks, crafts, music, etc.).
Encourage physical activity.
Use therapeutic touch.
Provide memory training (reflect on the past, make lists, etc.).
The longest stage of Alzheimer's Disease process is
Stage 2: lasts 2-12 years
Memory loss and confusion are irreversible
Dementia
Anhedonia is the lack of ______
Pleasure or joy
A 55-year-old client is worried about developing dementia because his father had Alzheimer's Disease at an early age. What lifestyle interventions would the nurse recommend that would potentially reduce this patient's risk of dementia? Select all that apply.
a) Drink alcohol daily
b) Play memory games
c) Control blood pressure
d) Avoid social activities
e) Control glucose levels, if diabetic
B - play memory games
C - control blood pressure
E - control glucose levels
a) Over a period of weeks to months
b) Over a period of hours to days
c) During late adulthood, middle age
d) In no relation to time or other condition
B - Over a period of hours to days
Typical onset age of a client diagnosed with Alzheimer's Disease.
ages between 60s - 70s
True or False:
A client who suddenly shows signs of delirium may simply be dehydrated.
True - dehydration may trigger a change in cognition, memory decline, or inability to follow instructions - symptoms associated with both dementia and delirium. The time is key here - abrupt/sudden change.
Dopamine levels are _________ in a client with schizophrenia
elevated
A nurse is caring for a client with Alzheimer's disease. The family asks about risk factors for this disease. Which of the following should the nurse include in their response? Select all that apply.
a) Exposure to metal waste products
b) Long-term estrogen therapy
c) Previous head injuries
d) History of exposure to toxins
e) Family history of Down syndrome
A - Exposure to metal waste products
C - Previous head injuries
D - History of exposure to toxins
E - Family history of Down syndrome
Medications that are appropriate in the treatment of schizophrenia include
Antipsychotics, mood stabilizers, and antidepressants
Definitive diagnostic tool to confirm Alzheimer's Disease
Autopsy
Clinical manifestations associated in a client with dementia include _________ (name 3)
Impaired Activities of Daily Living (ADLs)
Wandering
Memory decline/forgetful
Aphasia
Unable to follow instructions
Behavioral problems (agitation, restless)
Difficulty recalling events or persons
True/False:
Atypical (1st generation) antipsychotics treat both positive and negative symptoms.
False - 1st generation (Haldol, Chlorpromazine) treat mainly positive systems
Which of the following are considered positive symptoms of a client with schizophrenia? Select all that apply.
a) pressured speech
b) short-term memory deficits
c) hopelessness
d) anergia
e) grandeur delusions
A - pressured speech
E - grandeur delusions
Akathisia, dystonia, tardive dyskinesia, and neuroleptic malignant syndrome are __________________
Extrapyramidal Symptoms (associated with antipsychotics)
Which of the following medications is the only FDA-approved medication in the N-methyl-D-aspartate (NMDA) classification?
a) donepezil
b) memantine
c) galantamine
d) ginkgo biloba
B - memantine
The #1 priority nursing intervention for a client with dementia is _____________
Patient safety
Late-onset schizophrenia develops after ______ and more common in ______
age 40, women
A client with a diagnosis of delirium suddenly shouts that worms crawling all over their body. The nurse notes no evidence of worms. The nurse understands this experience is an indication of which symptom?
a) Dystonia
b) Tactile hallucinations
c) Hypermetamorphosis
d) Grandeur delusions
B - Tactile hallucinations
Name the 3 main components of cognition
attention, memory, perception