Alzheimer/ Dementia
What is the difference between Alzheimer's and dementia?
Alzheimer's is an irreversible disease that causes degenerative memory loss. Unknown patho, but thought to be due to neurofibrillary tangles caused by beta-amyloid neuritic plaques. Dementia is an umbrella term that is used to describe when the brain loses capabilities, such as communication, thinking, behavior, and feelings can be affected.
A new grad nurse is concerned that a client may be having a stroke due to a lack of symmetrical facial expressions that are symmetrical and having a tremor. What might the symptoms be besides a stroke?
Parkinson's - a mask-like expression is a common characteristic of this disease along with a tremor, stooped posture, arms/ elbows/ hips/ and hips flexed, slow shuffling gait.
who must be there when the client has their first sip after a stroke
the RN
List the two nicknames for hyperthyroidism and hypothyroidism
hypeRthyroidism- gRaves
hypOthyrodism - hashimOtOs
What is the normal range for blood glucose and A1C? What are they both measuring?
Blood Glucose: 70-100 measures current glucose levels in the blood
A1C: Less than 5.7%: Normal blood sugar levels, 5.7% to 6.4%: Prediabetes, 6.5% or higher: Diabetes. Tests average blood glucose over the past 2-3 months
How many stages of Alzheimer's are there? List them.
1. early/mild/first
2. middle/ moderate/ second
3. Late/ advanced/ third/ end
Parkinson's is a loss of dopamine-producing brain cells in the area of the brain that is responsible for motor activities. What area is these?
The substantia nigra of the basal ganglia
What type of stroke results from a blood clot that has traveled from a DVT
An embolic stroke (a type of ischemic stroke)
The other type of ischemic stroke is thrombotic secondary to a closet that developed in the cerebrum
A hemorrhagic stroke is secondary to a ruptured artery or aneurysm
Explain the negative feedback loop of the thyroid
The hypothalamus checks the hormone levels in the blood-brain barrier and if it low, sends TRH to the pituitary. The pituitary receives the TRH and releases TSH to the thyroid. The thyroid produces T3 and T4.
hypothyroidism- low T3/T4 so high TSH levels
hyperthyroidism- high T3/T4 so low TSH levels
What are the steps to drawing up Regular insulin mixed with NPH?
air into cloudy, air into clear, draw up clear, draw up cloudy
A new client comes in today with their daughter. The client is 86, and the daughter states a slow decline in the client's cognitive state, recent incontinence, wandering, and a decline in their ability to perform ADLs. The client has a history of smoking for 50 years, stopped in their 60s. The daughter thinks they have Alzheimer's. Will the client be diagnosed today?
No, a diagnosis can only be made via autopsy
Explain how MS affects the nervous system.
The blood-brain barrier is compromised, allowing T-cells to attach to the myelin sheath, causing demyelination
A client has a diagnosis of a stroke caused by a ruptured aneurysm. The client has facial droop, one-sided neglect, aphasia, and alexia. The onset of the stroke is 2 hours and 5 minutes, and they need urgent treatment. Do they qualify for t-PA
NO! This is hemorrhagic
qualifications for t-PA: confirmed diagnosis of an ischemic stroke, 3 hours of symptom onset maximum
What are the nursing precautions when dealing with a client with Graves' that is receiving radioiodine I-131?
Place clinet in a private room, place a caution 'radioactive material' sign on door, nursing should wear a dosimeter bandages at all times during interactions, staff are limited to 30 minutes of contact per 8 hr shift, staff need to rotate taking care of the client, do not assign a pregnant worker to this client, encourage the client to preform as much self care as possible.
list the four S's that cause hyperglycemia
Sepsis, Stress, Steroids, Skipped doses
A client with alzheimers presents with difficulty planning things, along with changes to mental state reported by friends and family. The client's daughter states the client likes the wonder off is concerned about the client's safety. What stage os Alzheimer's is the client at?
Stage two/ middle/ moderate/ second - this is the stage with wondering, the client may or may not be incontinent at this point. ADLs may or may not be affected.
True or false: A client can be diagnosed with MS via an ANA test and optical coherence tomography.
False: this is a rule-out diagnosis
Lyme disease titer to rule out lyme; MRI to check for lesions; ANA to rule of vasculitis; CBC with diff to check for inflammatory markers and WBC count; optical coherence tomography is used to check for optic neuritis
The client has had an ischemic stroke a presented with overstimulation, one-sided neglect, loss of depth perception, and poor impulse control. What hempishere was affected?
Right side
If it was left: aphasia, agnosia, alexia, agraphia, right-sided weakness, anger and frustration
What is the job of the parathyroid
Monitors and controls the amount of calcium and, in turn, phosphorus in the blood-brain barrier. There are four of them found on the thyroid
Hyperparathyroidism results in increased calcium and decreased phosphorus
Hypoparathyroidism results in decreased calcium and increased phosphorus
List five diabetic complications
HTN, artherosclerosis, retinopathy, renal faliure, nuropathy, infection, poor wound healing
Some treatments for Alzheimer's include deep brain stimulation, electrical neural stimulation, CSF shunts, etc. Name a medication that is used to treat Alzheimer's and how it works.
Donezpil, rivastigmine, galctamine all decrease or inhibit ACH
memanitine decreases glutamate
antipsyschotics and or anxiolytics may also be used
Immunomodulators, an immunosuppressant
once you start these treatments they are life long
List 8 risk factors for stroke
cerebral aneurysm, arteriovenous malformation, DM, obesity, HTN, atherosclerosis, hyperlipidemia, hypercoagulation, oral contraceptives, atrial fibrillation
What do T3 and T4 do?
burning calories, replace dying cells, metabolism/digest food, stimulate sympathetic nervous system (alertness, quick responsiveness/reflexes), increases body temperature and heart rate, brain development, muscle contraction, fertility, regulates TSH
List the four types of insulins along with their onset times.
Rapid-acting insulin
Onset: 10 to 30 minutes
Examples: Lispro (Humalog), Aspart (NovoLog), Glulisine (Apidra)
Short-acting insulin
Onset: 30 to 60 minutes
Example: Regular insulin (Humulin R, Novolin R)
Intermediate-acting insulin
Onset: 1 to 2 hours
Example: NPH insulin (Humulin N, Novolin N)
Long-acting insulin
Onset: 1 to 2 hours (some may take longer)
Examples: Glargine (Lantus, Basaglar), Detemir (Levemir), Degludec (Tresiba)