NSG 123 Medical Surgical Nursing: Exam 4 (Modules 8, 9,
10, 11)
State of temporary acute mental confusion. Usually develops over a 2-3 day person.
It is life-threatening & possibly preventable syndrome. Most frequent complication
of hospitalization in older adults. Priority of safety and treating underlying cause.
Delirium Definition
Delirium, often called acute confusional state, begins with disorientation and, if not
recognized and treated, can progress to changes in level of consciousness,
irreversible brain damage, and sometimes death
Initial symptoms are related to changes in cognitive function. The cognitive,
functional, and behavioral changes that characterize dementia eventually destroy a
person's ability to function. The symptoms are usually subtle in onset and often
Dementia Definition
progress slowly until they are obvious and devastating. Family members often
report to doctor: Memory loss, Mild disorientation, Trouble with words and/or
numbers Confusion:
Neglect or abuse of the patient can occur, and this has been documented in
home situations as well as in institutions. If neglect or abuse of any kind—including
Suspected Elderly Abuse physical, emotional, sexual, neglect, or financial abuse—is suspected, the local adult
protective services agency must be notified. The responsibility of the nurse is to
report the suspected abuse, not to prove it.
What is the point of medications in Slow the Progression
Alzheimer's?
What two categories of medications are Acetylcholinesterase inhibitor & N-methyl-D-aspartate receptor antagonist
used to treat Alzheimer's?
Alzheimer's
N-methyl-D-aspartate receptor antagonist:
Memantine- Namenda
Name? What Disease? What to watch for?
Decreases glutamate circulation in the brain
What does it do?
• Watch renal disease
, Acetylcholinesterase Inhibitor: Name? Alzheimer's
What Disease? What to watch for? What Increases uptake of acetylcholine (Donepezil- Aricept, Rivastigmine- Exelon)
does it do? • Watch liver disease
Symptoms: Tremor, Rigidity, Bradykinesoa (overall slowing of active movement),
Cardinal Signs of Parkinson's Postural Instability (postural and gait problems),
Gradual onset, symptoms progress slowly over a chronic, prolonged course
Although laboratory tests and imaging studies are not helpful to the clinician in
diagnosing PD ongoing research with PET and single-photon emission computed
tomography scanning has been helpful in understanding the disease and advancing
treatment. Currently, the disease is diagnosed clinically from the patient's history and
Diagnosis of Parkinsons: the presence of two of the four cardinal manifestations: tremor, rigidity, bradykinesia,
and postural changes. CT scan can show some chronic changes but will not change
long term outcomes. The medical history, presenting symptoms, neurologic
examination, and response to pharmacologic management are carefully evaluated
when making the diagnosis.
Confirmation Diagnosis of Parkinson's Give patient Levodopa-Carbodopa and see if they respond to it or not.
What does Levodopa do? & What disease Increases dopamine available in the brain
is it used in? Parkinson's
What does adding Carbidopa to Levodopa Adding Carbidopa can slow how quickly Levodopa is
do? What disease is it used in? absorbed Parkinson's
What is the brand name of Simemet
Carbidopa/Levodopa?
Why would a provider add Entacapone Works well in combo with Simemet
(Comtan) to a Sinemet medication
regimen?
What does Amatnadine (Symmetrel) do? increases dopamine release in the nigrostriatal pathway
Close monitoring of swallowing safety and intake
2 Things to Remember in Parkinson's:
Measure weights weekly
Best plan of care for Parkinson's? Medication Management
What is the desired effect of medication in Decrease of tremors, rigidity, and symptoms
Parkinson's?
Cranial arteritis is a cause of headache in the older population, reaching its greatest
incidence in those older than 70 years of age. Inflammation of the cranial arteries is
Cranial Arteritis Definition characterized by a severe headache localized in the reon of the temporal arteries.
The inflammation may be generalized (in which case cranial arteritis is part of a
vascular disease) or focal (in which case only the cranial arteries are involved).
Cranial arteritis often begins with general manifestations, such as fatigue, malaise,
weight loss, and fever. Clinical manifestations associated with inflammation (heat,
Symptoms of Cranial Arteritis
redness, swelling, tenderness, or pain over the involved artery) usually are present.
Sometimes a tender, swollen, or nodular temporal artery is visible.
The medical management of cranial arteritis consists of early administration of a
corticosteroid to prevent the possibility of loss of vision due to vascular occlusion or
Treatmnet of Cranial Arteritis rupture of the involved artery. The patient is instructed not to stop the medication
abruptly because this can lead to relapse. Analgesic agents are prescribed for
comfort.
First Stage
Symptoms may include depression, irritability, feeling cold, food cravings, anorexia,
Premonitory Stage of Migraine
change in activity level, increased urination, diarrhea, or constipation. Patients may
experience the same prodrome with each migraine headache
10, 11)
State of temporary acute mental confusion. Usually develops over a 2-3 day person.
It is life-threatening & possibly preventable syndrome. Most frequent complication
of hospitalization in older adults. Priority of safety and treating underlying cause.
Delirium Definition
Delirium, often called acute confusional state, begins with disorientation and, if not
recognized and treated, can progress to changes in level of consciousness,
irreversible brain damage, and sometimes death
Initial symptoms are related to changes in cognitive function. The cognitive,
functional, and behavioral changes that characterize dementia eventually destroy a
person's ability to function. The symptoms are usually subtle in onset and often
Dementia Definition
progress slowly until they are obvious and devastating. Family members often
report to doctor: Memory loss, Mild disorientation, Trouble with words and/or
numbers Confusion:
Neglect or abuse of the patient can occur, and this has been documented in
home situations as well as in institutions. If neglect or abuse of any kind—including
Suspected Elderly Abuse physical, emotional, sexual, neglect, or financial abuse—is suspected, the local adult
protective services agency must be notified. The responsibility of the nurse is to
report the suspected abuse, not to prove it.
What is the point of medications in Slow the Progression
Alzheimer's?
What two categories of medications are Acetylcholinesterase inhibitor & N-methyl-D-aspartate receptor antagonist
used to treat Alzheimer's?
Alzheimer's
N-methyl-D-aspartate receptor antagonist:
Memantine- Namenda
Name? What Disease? What to watch for?
Decreases glutamate circulation in the brain
What does it do?
• Watch renal disease
, Acetylcholinesterase Inhibitor: Name? Alzheimer's
What Disease? What to watch for? What Increases uptake of acetylcholine (Donepezil- Aricept, Rivastigmine- Exelon)
does it do? • Watch liver disease
Symptoms: Tremor, Rigidity, Bradykinesoa (overall slowing of active movement),
Cardinal Signs of Parkinson's Postural Instability (postural and gait problems),
Gradual onset, symptoms progress slowly over a chronic, prolonged course
Although laboratory tests and imaging studies are not helpful to the clinician in
diagnosing PD ongoing research with PET and single-photon emission computed
tomography scanning has been helpful in understanding the disease and advancing
treatment. Currently, the disease is diagnosed clinically from the patient's history and
Diagnosis of Parkinsons: the presence of two of the four cardinal manifestations: tremor, rigidity, bradykinesia,
and postural changes. CT scan can show some chronic changes but will not change
long term outcomes. The medical history, presenting symptoms, neurologic
examination, and response to pharmacologic management are carefully evaluated
when making the diagnosis.
Confirmation Diagnosis of Parkinson's Give patient Levodopa-Carbodopa and see if they respond to it or not.
What does Levodopa do? & What disease Increases dopamine available in the brain
is it used in? Parkinson's
What does adding Carbidopa to Levodopa Adding Carbidopa can slow how quickly Levodopa is
do? What disease is it used in? absorbed Parkinson's
What is the brand name of Simemet
Carbidopa/Levodopa?
Why would a provider add Entacapone Works well in combo with Simemet
(Comtan) to a Sinemet medication
regimen?
What does Amatnadine (Symmetrel) do? increases dopamine release in the nigrostriatal pathway
Close monitoring of swallowing safety and intake
2 Things to Remember in Parkinson's:
Measure weights weekly
Best plan of care for Parkinson's? Medication Management
What is the desired effect of medication in Decrease of tremors, rigidity, and symptoms
Parkinson's?
Cranial arteritis is a cause of headache in the older population, reaching its greatest
incidence in those older than 70 years of age. Inflammation of the cranial arteries is
Cranial Arteritis Definition characterized by a severe headache localized in the reon of the temporal arteries.
The inflammation may be generalized (in which case cranial arteritis is part of a
vascular disease) or focal (in which case only the cranial arteries are involved).
Cranial arteritis often begins with general manifestations, such as fatigue, malaise,
weight loss, and fever. Clinical manifestations associated with inflammation (heat,
Symptoms of Cranial Arteritis
redness, swelling, tenderness, or pain over the involved artery) usually are present.
Sometimes a tender, swollen, or nodular temporal artery is visible.
The medical management of cranial arteritis consists of early administration of a
corticosteroid to prevent the possibility of loss of vision due to vascular occlusion or
Treatmnet of Cranial Arteritis rupture of the involved artery. The patient is instructed not to stop the medication
abruptly because this can lead to relapse. Analgesic agents are prescribed for
comfort.
First Stage
Symptoms may include depression, irritability, feeling cold, food cravings, anorexia,
Premonitory Stage of Migraine
change in activity level, increased urination, diarrhea, or constipation. Patients may
experience the same prodrome with each migraine headache
