NSG 123 Medical Surgical Nursing: Exam 4 (Modules 8,
9, 10, 11)
1. Delirium Definition: 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, 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
2. Dementia Definition: Initial symptoms are related to changes in cognitive function. The
cognitive, function-
al, and behavioral changes that characterize dementia eventually destroy a person's ability to function.
The symptoms are usually subtle in onset and often 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:
3. Suspected Elderly Abuse: 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 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.
4. What is the point of medications in Alzheimer's?: Slow the Progression
5. What two categories of medications are used to treat
Alzheimer's?: Acetyl- cholinesterase inhibitor & N-methyl-D-aspartate receptor
antagonist
6. N-methyl-D-aspartate receptor antagonist: Name? What
Disease? What to watch for? What does it do?: Alzheimer's
Memantine- Namenda
Decreases glutamate circulation in the brain
• Watch renal disease
7. Acetylcholinesterase Inhibitor: Name? What Disease? What to
watch for? What does it do?: Alzheimer's
Increases uptake of acetylcholine (Donepezil- Aricept, Rivastigmine- Exelon)
• Watch liver disease
8. Cardinal Signs of Parkinson's: Symptoms: Tremor, Rigidity, Bradykinesoa (overall
slowing of active movement), Postural Instability (postural and gait problems),
Gradual onset, symptoms progress slowly over a chronic, prolonged course
, NSG 123 Medical Surgical Nursing: Exam 4 (Modules 8,
9, 10, 11)
9. Diagnosis of Parkinsons:: 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
, NSG 123 Medical Surgical Nursing: Exam 4 (Modules 8,
9, 10, 11)
patient's history and 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.
10. Confirmation Diagnosis of Parkinson's: Give patient Levodopa-Carbodopa an
see if they
respond to it or not.
11. What does Levodopa do? & What disease is it used in?: Increases
dopamine available in the brain
Parkinson's
12. What does adding Carbidopa to Levodopa do? What disease is
used in?: -
Adding Carbidopa can slow how quickly Levodopa is absorbed
Parkinson's
13. What is the brand name of Carbidopa/Levodopa?: Simemet
14. Why would a provider add Entacapone (Comtan) to a
Sinemet medication regimen?: Works well in combo with Simemet
15. What does Amatnadine (Symmetrel) do?: increases dopamine release in
the nigrostriatal pathway
16. 2 Things to Remember in Parkinson's:: Close monitoring of swallowing
safety and intake Measure weights weekly
17. Best plan of care for Parkinson's?: Medication Management
18. What is the desired effect of medication in Parkinson's?: Decrease of
tremors, rigidity, and symptoms
19. Cranial Arteritis Definition: 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 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).
20. Symptoms of Cranial Arteritis: Cranial arteritis often begins with general
manifestations, such as
fatigue, malaise, weight loss, and fever. Clinical manifestations associated with inflammation (heat,
redness, swelling, tenderness, or pain over the involved artery) usually are present. Sometimes a tender,
9, 10, 11)
1. Delirium Definition: 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, 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
2. Dementia Definition: Initial symptoms are related to changes in cognitive function. The
cognitive, function-
al, and behavioral changes that characterize dementia eventually destroy a person's ability to function.
The symptoms are usually subtle in onset and often 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:
3. Suspected Elderly Abuse: 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 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.
4. What is the point of medications in Alzheimer's?: Slow the Progression
5. What two categories of medications are used to treat
Alzheimer's?: Acetyl- cholinesterase inhibitor & N-methyl-D-aspartate receptor
antagonist
6. N-methyl-D-aspartate receptor antagonist: Name? What
Disease? What to watch for? What does it do?: Alzheimer's
Memantine- Namenda
Decreases glutamate circulation in the brain
• Watch renal disease
7. Acetylcholinesterase Inhibitor: Name? What Disease? What to
watch for? What does it do?: Alzheimer's
Increases uptake of acetylcholine (Donepezil- Aricept, Rivastigmine- Exelon)
• Watch liver disease
8. Cardinal Signs of Parkinson's: Symptoms: Tremor, Rigidity, Bradykinesoa (overall
slowing of active movement), Postural Instability (postural and gait problems),
Gradual onset, symptoms progress slowly over a chronic, prolonged course
, NSG 123 Medical Surgical Nursing: Exam 4 (Modules 8,
9, 10, 11)
9. Diagnosis of Parkinsons:: 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
, NSG 123 Medical Surgical Nursing: Exam 4 (Modules 8,
9, 10, 11)
patient's history and 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.
10. Confirmation Diagnosis of Parkinson's: Give patient Levodopa-Carbodopa an
see if they
respond to it or not.
11. What does Levodopa do? & What disease is it used in?: Increases
dopamine available in the brain
Parkinson's
12. What does adding Carbidopa to Levodopa do? What disease is
used in?: -
Adding Carbidopa can slow how quickly Levodopa is absorbed
Parkinson's
13. What is the brand name of Carbidopa/Levodopa?: Simemet
14. Why would a provider add Entacapone (Comtan) to a
Sinemet medication regimen?: Works well in combo with Simemet
15. What does Amatnadine (Symmetrel) do?: increases dopamine release in
the nigrostriatal pathway
16. 2 Things to Remember in Parkinson's:: Close monitoring of swallowing
safety and intake Measure weights weekly
17. Best plan of care for Parkinson's?: Medication Management
18. What is the desired effect of medication in Parkinson's?: Decrease of
tremors, rigidity, and symptoms
19. Cranial Arteritis Definition: 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 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).
20. Symptoms of Cranial Arteritis: Cranial arteritis often begins with general
manifestations, such as
fatigue, malaise, weight loss, and fever. Clinical manifestations associated with inflammation (heat,
redness, swelling, tenderness, or pain over the involved artery) usually are present. Sometimes a tender,
