Definitions
Process of acquiring knowledge & understanding through thought, experience & senses
Cognition
What are things that cause impaired cogniton?
Stroke, drugs, infection, diabetes, hypotension, cyanosis
A 5-year-old is awake and neurologically intact in all four extremities. When you ask what happened, she tells you she fell, and then she tells you about her Barbie
Eyes: 4
Verbal: 5
Motor: 6
Total: 15
What is the #1 intervention for impaired cognition?
FALL PREVENTION
Piaget's Stages of Development
The loss of the ability to speak or understand language
Aphasia
What is the most obvious S/S of impaired cognition?
Comatose/ decreased response to pain stimulus
When you apply pressure to injury, he extends his arms and legs and moans in pain shows no other response.
Eyes: 1
Verbal: 2
Motor: 2
Total: 5
What is the primary clinical management for impaired cognition?
prevention/ education
What happens in Piaget's preoperational stage ?
(2-7 years) Child learns through pretend play
The simultaneous use of multiple drug to treat a single ailment or condition
Polypharmacy
High risk factors for impaired cognition in elderly
Polypharmacy and INFECTION
An infant moves spontaneously towards an object and follows it, smiling and orienting towards interesting sounds. The infant opens their eyes spontaneously.
Eyes: 4
Verbal: 5
Motor: 6
Total: 15
What is the secondary clinical management?
GCS, imaging
What happens in Piaget's formal operational stage of development?
(11 & UP) Child gains deductive reasoning. (CAUSE & EFFECT)
How humans perceive or adapt to new information
Assimilation
S/S of altered cognition
anxiety, difficulty concentrating, sluggish/fixed pupils, no response to painful stimuli, comatose
A child withdraws from touch, can only sometimes be consoled and is often agitated. He opens his eyes in response to pain but not to speech.
Eyes: 5
Verbal: 4
Motor: 2
Total:11
What is the tertiary clinical management?
Gerontologic considerations
Decreased nerve conduction
Altered temperature regulation
Decreased perception of pain
Decreased senses
Decreased mental processing time
More likely to become confused with illness before other manifestations
The development and alterations of mental representations one encounters a new situation.
Accommodation
An infant moves her arm when touched, is inconsistently inconsolable and moans, but has no other response.
Eyes: 1
Verbal: 2
Motor: 5
Total: 8
Clinical management for nurses
SAFETY FIRST
1.Fall precautions
2. Airways
3. Reduce polypharmacy
4.Reorient (person, place, time)
5.Allow decision making when able to
6. Provide consistent routines