Stuff
Things
Huh?
Dude!
Whaaat?
100

Progressive, degenerative brain dysfunction, including deterioration in memory, concentration, language skills, visuospatial skills, and reasoning that interferes with a person’s daily functioning

What is dementia?

100

The spouse of a 67-yr-old male patient with early stage Alzheimer’s disease (AD) tells the nurse, “I am exhausted from worrying all the time. I don’t know what to do.” Which actions are best for the nurse to take next (select all that apply)?

a. Suggest that a long-term care facility be considered.

b. Offer ideas for ways to distract or redirect the patient.

c. Teach the spouse about adult day care as a possible respite.

d. Suggest that the spouse consult with the physician for antianxiety drugs.

e. Ask the spouse what she knows and has considered about dementia care options.

b. Offer ideas for ways to distract or redirect the patient 

c. Teach the spouse about adult day care as a possible respite 

e. Ask the spouse what she knows and has considered about dementia care options. 


Rationale: The stress of being a caregiver can be managed with a multicomponent approach. This includes respite care, learning ways to manage challenging behaviors, and further assessment of what the spouse may already have considered for care options. The patient is in the early stages and does not need long-term placement. Antianxiety medications may be appropriate, but other measures should be tried first

100

A state of confusion in which the victim is less aware of their surroundings and unable to comprehend or maintain attention?

What is Delirium?

100

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

What are assment findings of delirium?

100

A 59-yr-old female patient with a frontotemporal lobar dementia has difficulty with verbal expression. While her husband was at work, she walked to the gas station for a soda but did not understand the request for payment. What can the nurse suggest to keep the patient safe?

a.    Adult day care

b.    Assisted living

c.    Advance directives

d.    Monitor for behavioral changes

a. adult day care 


Rationale: To keep the patient safe during the day while the husband is at work, an adult day care facility would be the best choice. This patient would not need assisted living. Advance directives are important but are not related to her safety. Monitoring for behavioral changes will not keep her safe during the day.

200

Wernicke's is caused by a deficiency of this vitamin

What is thiamine (Vitamin B1)

200
These two substances can cause seizures when detoxing from them

What are alcohol and benzodiazepines?

200

Failure to concentrate, irritability, insomnia, no appetite, restlessness, confusion, and sometimes agitation, misperception, and hallucinations

What are signs and symptoms of delirium?

200

Which nursing intervention is most appropriate when caring for patients with dementia?

a.    Avoid direct eye contact.

b.    Lovingly call the patient “honey” or “sweetie.”

c.    Give simple directions, focusing on one thing at a time.

d.    Treat the patient according to their age-related behavior

What is 

c. Give simple directions, focusing on one thing at a time. 


Rationale: When dealing with patients with dementia, tasks should be simplified, giving directions using gestures or pictures and focusing on one thing at a time. It is best to treat these patients as adults, with respect and dignity, even when their behavior is childlike. The nurse should use gentle touch and direct eye contact. Calling the patient “honey” or “sweetie” can be condescending and does not show respect.

200

there is an ongoing pattern of uncooperative, defiant, and hostile behavior toward authority figures that seriously interferes with the youngster’s day to day functioning.

What is Oppositional Defiant Disorder

300

Detox from what drug causes frequent yawning, runny nose, diarrhea and restlessness?

What are opiates?

300

Nursing interventions for dementia that can be applied to the patients room

What are maintaing 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?

300

Infuse 1 Liter NS in 10 hours. Drop factor is 15 gtt/mL. Calculate the gtt/min

What is 25 gtt/min?

300
Encourage sleep, maintain safety and reduce clutter, provide visible clocks and calendars, ensure adequate nutrition, and supply oxygen for those patients with pneumonia
What are nursing interventions of delirium?
300

A chronic alcoholic is admitted to the medical unit for pneumonia. Which medication would the nurse expect the health-care provider to prescribe to prevent delirium tremors? a. chlordiazepoxide (Librium) b. Thiamine (vitamin B1) c. disulfiram (antabuse) d. fluoxetine (Prozac)

A. What is Librium?

400

4 types of dementia

What are Lewy Body, Alzheimers, frontal temporal, and vascular dementia?

400

The nurse in the long-term care facility cares for a 70-yr-old man with late-stage dementia who is undernourished and has problems chewing and swallowing. What should the nurse include in the plan of care for this patient?

a.    Limit fluid intake during mealtimes to prevent aspiration.

b.    Turn on the television to provide a distraction during meals.

c.    Provide thickened fluids and moist foods in bite-size pieces.

d.    Allow the patient to select favorite foods from the menu choices

What is 

c. Provide thickened fluids and moist foods in bite-sized pieces 


Rationale: If patients with dementia have problems chewing or swallowing, pureed foods, thickened liquids, and nutritional supplements should be provided. Foods that are easy to swallow are moist and should be in bite-size pieces. Distractions at mealtimes, including the television, should be avoided. Fluids should not be limited but offered frequently; fluids should be thickened. Patients with late-stage dementia have difficulty understanding words and would not have the cognitive ability to select menu choices.

400

The nurse has administered a dose of risperidone (Risperdal) to a patient with delirium. What finding demonstrates the intended effect of the medication?

a.    Lying quietly in bed

b.    Alleviation of depression

c.    Reduction in blood pressure

d.    Disappearance of confusion

What is a-lying quietly in bed.  Rationale: Risperidone is an antipsychotic drug that reduces agitation and produces a restful state in patients with delirium.

400
Potential delirium nursing diagnoses
What is risk for trauma, disturbed thought process, or self care deficit?
400

A nurse is caring for a client who has been prescribed disulfiram (Antabuse) as a deterent to alcohol relapse. Which info should the nurse include when teaching the client about this medication? a. "only oral ingestion of alcohol will cause a reaction when taking this drug" b. "it is safe to drink beverages that have only 12% alcohol content" c. "this medication will decrease your cravings for alcohol" d. "reactions to combining antabuse with alcohol can occur 2 weeks after stopping the drug."

What is d. "reactions to combining antabuse with alcohol can occur 2 weeks after stopping the drug."

500

Change that interferes with social and occupational function, gradual onset, continuing decline, no other condition causing syptoms, impaired short or long term memory and either impaired executive function, aphasia, apraxia, agnosia.

What is the criteria to diagnose dementia?

500

Name 3 symptoms of alcohol withdrawal

What are anxiety, hypertension, sweating, tremors, headache, N/V, visual disturbances

500

The type of dementia resulting from a series of small strokes or TIAs in the brain.

What is neurovascular dementia?

500
Pharmalogical methods for delirium
What are low dose antipsychotics and short acting benzodiazepines?
500

The day shift nurse at the long-term care facility learns that a patient with dementia experienced sundowning late in the afternoon on the previous two days. Which action should the nurse take?

a. Have the patient take a mid-morning nap.

b. Keep window blinds open during the day.

c. Provide hourly orientation to time and place.

d. Move the patient to a quiet room in the afternoon

b. Keep window blinds open during the day 


Rationale: A likely cause of sundowning is a disruption in circadian rhythms, and keeping the patient active and in daylight will help reestablish a more normal circadian pattern. Moving the patient to a different room might increase confusion. Taking a nap will interfere with nighttime sleep. Hourly orientation will not be helpful in a patient with dementia