FNP Board Review: Problems of Older Adult
(Fitzgerald) 100% Correct Answers | Verified |
Latest 2024 Version
____________ is a sudden state of rapid changes in brain function reflected in confusion, changes in
cognition, activity, and level of consciousness. - ✔✔Delirium
____________ is a slowly developing impairment of intellectual or cognitive function that is progressive
and interferes with normal functioning - ✔✔Dementia
T/F: Delirium is precipitated by an underlying acute cause, such as acute illness whereas a dementia has
a variety of causes - ✔✔True
With dementia there are psychomotor changes _______(early or late) in the disease - ✔✔Late
What is important (related to medications) to look at when assessing a patient with delirium? - ✔✔The
last medication added or dose adjusted
What are some problematic medications in the elderly related
To delirium? - ✔✔Systemic Anticholinergics -TCA
- FIRST-generation antihistamines (diphenhydramine)
- antipsychotics (Haldol)
- Opioids
- Benzodiazepines
- Alcohol
Which electrolyte disturbance in particular could cause delirium? - ✔✔Hyponatremia
Reasons for hyponatremia in the elder? - ✔✔Elder kidney can not conserve sodium plus we give elders
lots of hyponatremia causing medications like thiazides
,What are the most common infections in the elderly that can cause delirium? - ✔✔UTI (#1) , CAP (#2)
Delirium Mnemonic - ✔✔Drugs
Emotional
Electrolyte
Low PO2
Lack of Drugs
Infection
Retention
Reduced sensory input
Ictal or postictal state
Undernutrition
Metabolic
Myocardial Problems
Subdural Hematoma
Delirium mnemonic - ✔✔•Drugs—When any medication is added or dose is adjusted. Particularly
problematic medications include anticholinergics (tricyclic antidepressants [TCAs], firstgeneration
antihistamines), neuroleptics (haloperidol, others), opioids (in particular, meperidine), longacting
benzodiazepines (diazepam, clonazepam), and alcohol. •Emotional (mood disorders, loss); Electrolyte
disturbance, especially hyponatremia. •Low PO2 (hypoxemia from CAP, COPD, PE, MI); Lack of drugs
(withdrawal from alcohol, other habituating substances). •Infection—Urinary tract infection and
communityacquired pneumonia (the most common delirium trigger). •Retention of urine or feces;
Reduced sensory input (blindness, deafness, darkness, change in surroundings). •Ictal or postictal
state—Alcohol withdrawal is a common reason for an isolated first seizure in an older adult. •Under-
nutrition—Protein/calorie, vitamin B12, or folate deficiency, dehydration including postoperative volume
disturbance.
•Metabolic (poorly controlled diabetes mellitus, undertreated or untreated hypothyroidism or
hyperthyroidism); Myocardial problems (myocardial infarction, heart failure, dysrhythmia). •Subdural
hematoma—Can be as a result of relatively minor head trauma to brain atrophy, fragile vessels.
Metabolic reasons for delirium - ✔✔Poorly controlled diabetes
, Undertreated hypo or hyper thyroid
T/F: Either gender over age 80 most commonly present with dysthymia and confusion in ACS - ✔✔True
What was the first "name" for pernicious anemia? - ✔✔Megaloblastic mania
Most dementia is ______-type dementia - ✔✔Alzheimer's type
20% of dementia is ______-type dementia - ✔✔Vascular
5% of dementia is ______-type dementia - ✔✔Parkinson's
Miscellaneous causes of dementia - ✔✔HIV
Dialysis encephalopathy
Neurosyphilis
Normal pressure hydrocephalus
Lewy body disease
Frontotemporal dementia
T/F: About 30% with Alzheimer's type dementia also have vascular dementia - ✔✔True
To slow AD decline use Vitamin _____, ________ IUs twice daily - ✔✔Vitamin E, 1000 IUs BID
An alternative to vitamin E, 1000 IUs daily use ____________ at 5mg BID. - ✔✔Selegiline
In mild to moderate stage dementia disease the use of the __________inhibitors is considered to be the
mainstay of treatment - ✔✔Cholinesterase
(Fitzgerald) 100% Correct Answers | Verified |
Latest 2024 Version
____________ is a sudden state of rapid changes in brain function reflected in confusion, changes in
cognition, activity, and level of consciousness. - ✔✔Delirium
____________ is a slowly developing impairment of intellectual or cognitive function that is progressive
and interferes with normal functioning - ✔✔Dementia
T/F: Delirium is precipitated by an underlying acute cause, such as acute illness whereas a dementia has
a variety of causes - ✔✔True
With dementia there are psychomotor changes _______(early or late) in the disease - ✔✔Late
What is important (related to medications) to look at when assessing a patient with delirium? - ✔✔The
last medication added or dose adjusted
What are some problematic medications in the elderly related
To delirium? - ✔✔Systemic Anticholinergics -TCA
- FIRST-generation antihistamines (diphenhydramine)
- antipsychotics (Haldol)
- Opioids
- Benzodiazepines
- Alcohol
Which electrolyte disturbance in particular could cause delirium? - ✔✔Hyponatremia
Reasons for hyponatremia in the elder? - ✔✔Elder kidney can not conserve sodium plus we give elders
lots of hyponatremia causing medications like thiazides
,What are the most common infections in the elderly that can cause delirium? - ✔✔UTI (#1) , CAP (#2)
Delirium Mnemonic - ✔✔Drugs
Emotional
Electrolyte
Low PO2
Lack of Drugs
Infection
Retention
Reduced sensory input
Ictal or postictal state
Undernutrition
Metabolic
Myocardial Problems
Subdural Hematoma
Delirium mnemonic - ✔✔•Drugs—When any medication is added or dose is adjusted. Particularly
problematic medications include anticholinergics (tricyclic antidepressants [TCAs], firstgeneration
antihistamines), neuroleptics (haloperidol, others), opioids (in particular, meperidine), longacting
benzodiazepines (diazepam, clonazepam), and alcohol. •Emotional (mood disorders, loss); Electrolyte
disturbance, especially hyponatremia. •Low PO2 (hypoxemia from CAP, COPD, PE, MI); Lack of drugs
(withdrawal from alcohol, other habituating substances). •Infection—Urinary tract infection and
communityacquired pneumonia (the most common delirium trigger). •Retention of urine or feces;
Reduced sensory input (blindness, deafness, darkness, change in surroundings). •Ictal or postictal
state—Alcohol withdrawal is a common reason for an isolated first seizure in an older adult. •Under-
nutrition—Protein/calorie, vitamin B12, or folate deficiency, dehydration including postoperative volume
disturbance.
•Metabolic (poorly controlled diabetes mellitus, undertreated or untreated hypothyroidism or
hyperthyroidism); Myocardial problems (myocardial infarction, heart failure, dysrhythmia). •Subdural
hematoma—Can be as a result of relatively minor head trauma to brain atrophy, fragile vessels.
Metabolic reasons for delirium - ✔✔Poorly controlled diabetes
, Undertreated hypo or hyper thyroid
T/F: Either gender over age 80 most commonly present with dysthymia and confusion in ACS - ✔✔True
What was the first "name" for pernicious anemia? - ✔✔Megaloblastic mania
Most dementia is ______-type dementia - ✔✔Alzheimer's type
20% of dementia is ______-type dementia - ✔✔Vascular
5% of dementia is ______-type dementia - ✔✔Parkinson's
Miscellaneous causes of dementia - ✔✔HIV
Dialysis encephalopathy
Neurosyphilis
Normal pressure hydrocephalus
Lewy body disease
Frontotemporal dementia
T/F: About 30% with Alzheimer's type dementia also have vascular dementia - ✔✔True
To slow AD decline use Vitamin _____, ________ IUs twice daily - ✔✔Vitamin E, 1000 IUs BID
An alternative to vitamin E, 1000 IUs daily use ____________ at 5mg BID. - ✔✔Selegiline
In mild to moderate stage dementia disease the use of the __________inhibitors is considered to be the
mainstay of treatment - ✔✔Cholinesterase
