Dementia
Define dementia
What is a progressive, degenerative brain dysfunction, including deterioration in memory, concentration, language skills, visuospatial skills, and reasoning that interferes with a person’s daily functioning
We use these diagnostic tools to assess for dementia
What are the Mini-Cog test or the Mental Status Assessment?
Define delirium
What is an acute confusional state?
These are the assessment findings of delirium
What is altered level of consciousness, fluctuating during the day, short attention span, easily distracted, physiological changes, disorganized thinking, cognitive-perseptual changes, impaired memory, and loud and incoherent speech?
These risk factors contribute to both dementia and delirium
What are age, pre-existing cognitive abnormalities, the presence of metabolic abnormalities, and treatment with psychoactive and anticholinergic drugs?
Provide 4 signs or symptoms of moderate dementia
What are difficulty with language, difficulty with reasoning, inability to learn new things, agitation, anxiety, wandering, repetitive statements/questions, hallucinations, delusions, paranoia, irritability
Nursing diagnoses related to dementia include these
What is chronic confusion related to neurological dysfunction, functional urinary incontinence r/t neuromuscular impairment, self neglect r/t cognitive impairment, self-care deficit r/t psychological impairment, risk for falls r/t diminished mental status, risk for injury r/t confusion, risk for impaired skin integrity r/t immobility
Common signs and symptoms of delirium
What is failure to concentrate, irritability, insomnia, no appetite, restlessness, confusion, and sometimes agitation, misperception, and hallucinations?
The reason the CAM (Confusion Assessment Method) test is administered
What is to measures the acute onset of fluctuating course, inattention, disorganized thinking, and altered level of consciousness?
Name the two most common causes of dementia
What are neurodegenerative conditions and vascular disorders
These are nursing interventions that take place in the room of a dementia patient
What are maintaining a comfortable room temperature, avoiding throw rugs, keeping a clear pathway to the bathroom, write name and date to orient the patient, and providing adequate lighting?
Delirium usually continues for this length of time
What is 1 - 7 days?
Common nursing interventions for patients with delirium
What are encourage sleep, maintain safety and reduce clutter, provide visible clocks and calendars, ensure adequate nutrition, and supply oxygen for those patients with pneumonia?
Define and explain retro genesis
What is the process where degenerative changes occur in the reverse order to which they were acquired. For example we learn to walk first, then we learn to dress ourselves. In AD, we lose the ability to dress ourself, then lose the ability to walk.
4 types of dementia
What are Lewy Body, frontal Lobe, frontal temporal, and vascular dementia?
Two examples of caregiver teaching for the family members of a patient with dementia
What are how to care for their loved one with dementia, safety measure that need to be put into place, or talking about the possibility of hospice care
This percentage of patients experience delirium in the invasive care setting
What is 70 - 85%? (Especially geriatric patients, and patients in the ICU)
Potential nursing diagnoses for patients with delirium include these three things
What is risk for trauma, disturbed thought process, and self care deficit?
Alzheimer's is diagnosed in this manner
What is diagnosis by exclusion. The diagnosis is made once all other possible conditions causing cognitive impairment have been ruled out. Formal diagnosis can only occur post-mortem
Three of the criteria to diagnose dementia
What are changes that interferes with social and occupational function, gradual onset, continuing decline, no other condition causing symptoms, impaired short or long term memory and either impaired executive function, aphasia, apraxia, agnosia.
Pharmacotherapy for dementia
What are Cholinesterase Inhibitors (CEIs), N-methyl-D-aspartate receptor antagonists, Serotonin reuptake inhibitors, and Antipsychotics?
What are strokes, dementia, CNS infections, and Parkinson’s disease?
Pharmacotherapy for delirium
What is low dose antipsychotics and short acting benzodiazepines?
Four overall goals for patients with Alzheimers
What are to maintain functional ability as long as possible, to be maintained in a safe environment with a minimum of injuries, to have personal care needs met, and to have dignity maintained