Delirium
What are the 3 D's?
Delirium, Dementia, and Depression
What dementia has presence of amyloid plaques in the brain?
Alzheimer's Disease
Which dementia has fluctuating cognition, recurrent visual hallucinations, and has REM sleep behavior?
Lewy Body Dementia
What are the 4 schizophrenia spectrum disorders?
Schizophrenia
Schizoaffective
Schizophreniform
Schizotypal personality disorder
Difference between factitious disorder and malingering syndrome
Factitious disorder falsifies their symptoms but with no reward for doing so.
Malingering Syndrome falsifies symptoms for personal gain (faking illness to get out of work)
What sets delirium apart from depression or dementia
Quick onset
Altered consciousness
Usually reversible once underlying cause is treated
What is the definition of agnosia?
Cannot recognize objects, people, sounds, shapes, or smells.
What domain is effected when the pt can focus on only one task at a time, and needs others to plan activities and make decisions.
Executive function
5 A's
Affect (flat affect)
Alogia (decreased thought or speech)
Anergia (lack of energy)
Anhedonia (lack of pleasure in activities)
Avolition (lack motivation to do activities)
What are some signs of mania?
Inflated self esteem
Poor judgment
Racing thoughts
Overspending
Hypersexual
Not sleeping well
Verbose speech (use of more words than necessary)
Fast speech
What is delirium tremens
Rapid onset of irritability, confusion, tremors, nausea, vomiting, and seizures caused by withdrawal from substances.
What domain is effected when pt presents difficulty in environments with multiple stimuli, is easily distracted, needs simple and restricted input, and takes longer to process things?
Complex Attention
A patient makes up stories to prevent admitting loss of memory is exhibiting what behavior?
Confabulation
What are the diagnosis criteria of Schizophrenia
Typically diagnosed between 16 and 30.
Can appear earlier in clients assigned male at birth.
Must have 2 or more symptoms present for a period of 1 month or longer w/ signs of continuous disturbance for at least 6 months.
Impairment in one area of major functioning.
What are some comorbidities for dissociative disorders
Anxiety
Bipolar disorder
Genetics
Substance use
What medical conditions can manifest as delirium?
Withdrawal from substance use
Dehydration
Electrolyte imbalances
Infection (UTI, pneumonia)
Hepatic encephalopathy
Thyroid disease
Medications (lithium, levodopa, tricyclic antidepressants, benzos, CNS depressants, digitalis and steroids)
A nurse is speaking with the caregiver of a client who has dementia about including omega-3 fatty acids in the client's diet. Which of the following foods should the nurse recommend?
Fruits w/ seeds
Chicken
Red meat
Leafy vegetables
Leafy vegetables
The nurse should recommend the client consume green leafy vegetables. Green leafy vegetables are high in omega-3 fatty acids, which promote cognitive function for clients who have dementia. Other foods high in omega-3 fatty acids are fish and nuts.
What clinical presentations are in the moderate stage of dementia?
Needs prompting and assistance for hygiene and dressing.
Inappropriate or misplaced emotions.
Requires moderate assistance with activities of daily living.
A nurse is caring for a client who has been diagnosed w/ schizophrenia. Which of the following findings indicated that the client is in the residual phase of the disorder?
No longer showing any noticeable negative symptoms.
Experiencing regular hallucinations and delusions
Extended periods of disorganized thought and speech
Decline in symptoms of psychosis
Decline in symptoms of psychosis.
A nurse should expect a client who is in the residual phase of schizophrenia to exhibit less severe and regular psychotic symptoms.
What are some warning signs of suicide?
Talking about hopelessness
Withdrawing from others
Sudden mood changes
Giving away possessions
Stating they will kill themselves
Obsessive thoughts or talking about death
Stating they feel trapped
Stating pain emotional or physical is unbearable
A nurse is caring for a client who is experiencing delirium. Which of the following findings should the nurse expect?
Sundowning
Shuffling gait
Rapid eye movement during sleep
Tremors
Tremors
The nurse should expect a client who has delirium to exhibit manifestations of tremors, tachycardia, confusion, sweating, hyperactivity, and hallucinations.
A nurse is caring for a client who has Huntington's disease dementia. Which of the following manifestations should the nurse expect?
Impulsive behaviors
Apathy
Shuffling gait
Depressed mood
Impulsive behaviors
The nurse should expect a client who has Huntington's disease dementia to exhibit impulsive behaviors. Other manifestations can include dysarthria, impaired gait, and irritability.
A nurse is caring for an older client who has dementia which of the following findings should the nurse expect?
Unable to remember names of restaurants
Misplacing keys
Forgetting apt dates
Inability to manage finances
In ability to manage finances
The nurse should expect a client who has dementia to be unable to perform calculations such as managing their finances. Clients who have dementia might also exhibit poor judgment and attention span, along with impaired memory and abstract thinking.
A nurse is providing discharge instructions for a client who is prescribed clozapine. Which of the following information should the nurse include?
The medication only treats negative symptoms
The medication takes full effect in one week
Weekly blood draws will be done while taking this medication
The medication requires monitoring of RBC
Weekly blood draws will need to be done while taking this medication.
It is critical that the nurse discuss the need for weekly blood draws. Clozapine can cause agranulocytosis and place the client at risk for infection. The client should report manifestations of infection to the provider immediately.
What are Cluster B personality disorders?
Dramatic, erratic, and emotional behavior
Antisocial: Exploitation, manipulation, and deceit of others. No responsibility.
Borderline: Excessive emotional reactions. Frantic, dramatic, attention seeking, overly expressive. High risk of SI
Histrionic: Attention seeking, seductive
Narcissistic: Arrogant, need for constant admiration, lack of empathy