Term
Topic 1: Cognitive Disorders
Causes of Delirium? |
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Definition
- Central Nervous Disease (encephalitis, epilepsy, neoplasms)
- Drugs and poisons (intoxication or withdrawal)
- Neurological Disease
- Endocrine Dysfunction
- Metabolic Disorders
- Electrolyte Imbalance
- Infections
- Post op states
- Psychosocial stressors |
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Term
Topic 1: Cognitive Disorders
Assx of a pt with a cognitive disorder? |
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Definition
- The Folstein Mini-Mental Status Exam (MMSE)
- Psychogeriatric Assessment scales
- Mental Status Examination (MSE)
- Clifton Assessmen Procedures for the Elderly (CAPE)
- Suicide and Self-harm Risk Assessment
- Physical Assessment |
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Term
Topic 1: Cognitive Disorders
Diagnostic considerations used by doctors to rule out causes of DEMENTIA? |
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Definition
D - Drug Interaction?
E - Emotional disturbance/crises/loss?
M - Metabolic/Endocrine problems (diabetes/thyroid?)
E - Eyes and ears?
N - Nutritional Deficiencies (?Vit b12)
T - Tumor/Trauma?
I - Infection/brain abscess?
A - Arteriosclerosis? |
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Term
Topic 1: Cognitive Disorders
Cognitive Disorders involve impairment to... |
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Definition
- Reasoning
- Judgement
- Perception
- Attention
- Comprehension
- Memory
- *sometimes* Language |
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Term
Topic 1: Cognitive Disorders
What is delirium? |
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Definition
| An acute and reversible condition secondary to an underlying disorder that causes temporary, diffuse disturbances of brain functions. |
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Term
Topic 1: Cognitive Disorders
What are the main features of Delirium? |
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Definition
- Sudden Onset
- Brief and fluctuation course
- Reversible when cause is eliminated
- Syndrome, not a disease |
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Term
Topic 1: Cognitive Disorders
Characteristic CMs of Delirium? |
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Definition
- Disturbance of consciousness (dec. awareness, shift in attention span, focus, confusion**)
- Cognitive Changes (memory deficit, disorientation, language distubance)
- Psychotic sympx (visual hallucinations and paranoid delusions)
- Abnormalities in motor activity
- Emotional changes (fear)
- Agnosia (naming objects), Dysgraphia (writing)
- Sundowning |
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Term
Topic 1: Cognitive Disorders
Treatment for Delirium? |
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Definition
*Treat underlying cause*
- If untreated - perm. brain injury may ensue
- Support and needs:
- physical, sensory and environmental
- reality orientation
- lower anxiety
- use of simple concrete phrases |
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Term
Topic 1: Cognitive Disorders
What is Dementia? |
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Definition
| A progressive cognitive disorder associated with the deposition of beta-amyloid protein in and around nerve cells of the brain. |
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Term
Topic 1: Cognitive Disorders
Characteristic CMs of Dementia? |
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Definition
Alzheimer's Disease:
- Memory loss (ST)
- Language Imp (3 A's)
- Decline in fine motor skills
- Disorientation
- Loss of recognition skills
- Onset b/w 40-90yrs
- 10% experience epileptic seizures in later stages |
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Term
Topic 1: Cognitive Disorders
Comparison:
Delirium:
- Sudden onset, within days
- No sleep disturbance
- Cognitive awareness and alertness fluctuates, worse at night (sundowning)
- ACS
- Visual hallucinations |
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Definition
Topic 1: Cognitive Disorders
Comparison:
Dementia:
- Slow, insidious onset
- sleep disturbance present
- no changes to alertness
- no ACS
- Rarely hallucinations |
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Term
Topic 1: Cognitive Disorders
Distinguish between primary and secondary Dementia. |
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Definition
Primary: not reversible, is progressive and is not secondary to any other disorder.
Secondary: as a result of some other pathological process. Treatable if underlying cause is able to be eliminated. |
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Term
Topic 1: Cognitive Disorders
Name the reversible and potentially treatable dementia causes. |
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Definition
Reversible:
- Delirium
- Secondary dementia |
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Term
Topic 1: Cognitive Disorders
Irreversible cognitive disorders: |
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Definition
- Alzheimer's Disease
- Vascular Dementia (multi-infarct dementia -silent strokes)
- Mixed Alzheimer's and vascular
- Parkinson's disease
- Pick's disease
- Creutfeldt-Jakob disease
- AIDs, Down Syndrome |
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Term
Topic 1: Cognitive Disorders
Management of dementia pts: |
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Definition
- SAFETY: Maintain a safe, therapeutic environment.
- Identify Medical needs of the pt
- Provide supportive psychological care
- Maintain ADL's and status of functioning (independence)
- Educate the pt, family and carers on disease process
- Maintain consistency in daily care |
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Term
Topic 1: Cognitive Disorders
Pharmacotherpy for Dementia: |
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Definition
- Benzodiazepines: insomnia/anxiety
- Antidepressants: SSRIs b/c less EPSs
- Anti-psychotics: delusions/hallucinations
- Anti-Alzheimer's Agents:
-*Cholinesterase inhibitors decrease cognitive defects but have severe liver and GI side-effects
- Vitamin E: decreases functional decline
- MAOI (Selegiline): may delay cognitive deterioration |
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