NR 326 Mental Health Exam 2 Review
, Mental Health Exam 2 Review
Neurocognitive Disorders (15)
Alzheimer’s/dementia- 11:
Dementia: Multiple cognitive deficits that impair memory and can affect language, motor skills, and/or
abstract thinking
Signs of Dementia
-Poor judgement and decision making
-Losing track of date or season
-Difficulty having conversations
-Misplacing things and unable to retrace steps
-Up to 50% of mild cognitive impairments develop dementia within 3 years.
-Confabulation
Alzheimer’s: a subtype of neurocognitive disorder that is neurodegenerative, resulting in the gradual
impairment of cognitive function. Depression in older adult mimics the early stages of Alzheimer's
disease.
Alzheimer's disease (AD)
Nonreversible type of dementia that progressively develops over many years. A special framework
made up of seven stages has been designed to categorize the disease and its manifestations. The
framework is based on three general stages: early stage, mid stage, and late stage.
● Some people die 4 to 6 years after diagnosis, but others can live with the disease for up to 20 years.
● AD is responsible for 60% of dementia cases in clients over 65 years of age. Manifestations may
appear in clients in their 40s, which is referred to as presenile or early dementia, Alzheimer's type.
● Age is the number one known risk factor for AD, which usually occurs after the age of 65.
● AD is characterized by memory loss, problems with judgment, and changes in personality.
● Severe physical decline occurs along with deteriorating cognitive functions.
Risk Factors
◯ Advanced age
◯ Genetic predisposition
◯ Environmental agents (herpes virus, metal, or toxic waste)
◯ Previous head injury
, ◯ Sex (female)
Nursing care
Assess cognitive status, memory, judgment, and personality changes.
Initiate bowel and bladder program with the client based on a set schedule.
Encourage the client and family to participate in an AD support group.
Provide a safe environment.
Keep the client on a sleeping schedule and monitor for irregular sleeping patterns.
Provide verbal and nonverbal ways to communicate with the client.
Offer snacks or finger foods if the client is unable to sit for long periods of time.
Check the client's skin weekly for breakdown.
Provide cognitive stimulation.
■ Offer varied environmental stimulations, such as walks, music, or craft activities.
■ Keep a structured environment and introduce change gradually (client's daily routine or a
roomchange).
■ Use a calendar to assist with orientation.
■ Use short directions when explaining an activity or care the client needs, such as a bath.
■ Be consistent and repetitive.
■ Use therapeutic
touch.Provide memory
training.
■ Reminisce with the client about the past.
■ Use memory techniques such as making lists and rehearsing.
Delirium-2: R
F for delirium
Neurological- Parkinson’s, Huntington’s, Metabolic- hepatic or renal failure, electrolyte imbalances,
nutritional deficiencies, CV/resp diseases, Surgery, Substance use
Delirium
- rapid onset
- impairment in memory, judgement, ability to focus, and ability to calculate
- can fluctuate throughout the day
- LOC alteration
- restlessness, anxiety, motor agitations
- hallucinations and illusions
- unstable vitals
- medical emergency
- reversible if treatment prompt
, Mental Health Exam 2 Review
Neurocognitive Disorders (15)
Alzheimer’s/dementia- 11:
Dementia: Multiple cognitive deficits that impair memory and can affect language, motor skills, and/or
abstract thinking
Signs of Dementia
-Poor judgement and decision making
-Losing track of date or season
-Difficulty having conversations
-Misplacing things and unable to retrace steps
-Up to 50% of mild cognitive impairments develop dementia within 3 years.
-Confabulation
Alzheimer’s: a subtype of neurocognitive disorder that is neurodegenerative, resulting in the gradual
impairment of cognitive function. Depression in older adult mimics the early stages of Alzheimer's
disease.
Alzheimer's disease (AD)
Nonreversible type of dementia that progressively develops over many years. A special framework
made up of seven stages has been designed to categorize the disease and its manifestations. The
framework is based on three general stages: early stage, mid stage, and late stage.
● Some people die 4 to 6 years after diagnosis, but others can live with the disease for up to 20 years.
● AD is responsible for 60% of dementia cases in clients over 65 years of age. Manifestations may
appear in clients in their 40s, which is referred to as presenile or early dementia, Alzheimer's type.
● Age is the number one known risk factor for AD, which usually occurs after the age of 65.
● AD is characterized by memory loss, problems with judgment, and changes in personality.
● Severe physical decline occurs along with deteriorating cognitive functions.
Risk Factors
◯ Advanced age
◯ Genetic predisposition
◯ Environmental agents (herpes virus, metal, or toxic waste)
◯ Previous head injury
, ◯ Sex (female)
Nursing care
Assess cognitive status, memory, judgment, and personality changes.
Initiate bowel and bladder program with the client based on a set schedule.
Encourage the client and family to participate in an AD support group.
Provide a safe environment.
Keep the client on a sleeping schedule and monitor for irregular sleeping patterns.
Provide verbal and nonverbal ways to communicate with the client.
Offer snacks or finger foods if the client is unable to sit for long periods of time.
Check the client's skin weekly for breakdown.
Provide cognitive stimulation.
■ Offer varied environmental stimulations, such as walks, music, or craft activities.
■ Keep a structured environment and introduce change gradually (client's daily routine or a
roomchange).
■ Use a calendar to assist with orientation.
■ Use short directions when explaining an activity or care the client needs, such as a bath.
■ Be consistent and repetitive.
■ Use therapeutic
touch.Provide memory
training.
■ Reminisce with the client about the past.
■ Use memory techniques such as making lists and rehearsing.
Delirium-2: R
F for delirium
Neurological- Parkinson’s, Huntington’s, Metabolic- hepatic or renal failure, electrolyte imbalances,
nutritional deficiencies, CV/resp diseases, Surgery, Substance use
Delirium
- rapid onset
- impairment in memory, judgement, ability to focus, and ability to calculate
- can fluctuate throughout the day
- LOC alteration
- restlessness, anxiety, motor agitations
- hallucinations and illusions
- unstable vitals
- medical emergency
- reversible if treatment prompt
