Neurocognitive Disorders

Define delirium

A disturbance in attention that develops over a short period of time, with an additional disturbance in cognition.

What manifestations should a nurse expect from a client w/ Parkinson's disease dementia?

A shuffling gait A client who has Parkinson's disease dementia can exhibit a shuffling gait. Other manifestations include depressed mood, apathy, hallucinations, personality changes, daytime sleepiness, rapid eye movement during sleep

major neurocognitive disorder

A wide variety of disorders of cognitive functioning (memory, social skills, reasoning, and intellectual ability), formerly called dementia.

At what age does the risk of vascular disease increases exponentially?

After age 65.

The DSM-5-TR uses the term "insidious onset and gradual progression of impairment" to describe the progression of the decline of clients who have major or mild neurocognitive disorder due to what disease?

Alzheimer's disease

A nurse suspects a client might have frontotemporal lobar degeneration dementia. What test would the provider prescribe to confirm this diagnosis?

Computed tomography The nurse should identify that a computed tomography (CT) scan can detect atrophy of the brain, which can indicate frontotemporal lobar degeneration dementia. The provider would not use a PET scan.

A nurse is caring for a client who has been diagnosed with "mad cow disease." The nurse should identify that the client has which of the following types of dementia?

Creutzfeldt-Jakob disease (CJD) The nurse should identify that the client has prion disease dementia or CJD, also known as "mad cow disease." This disease is transmitted from animal to human from a prion typically found in contaminated beef that is consumed by the client.

Criteria for Alzheimer's diagnosis as a major cognitive disorder

Evidence of a genetic mutation from genetic testing and/or family history and All of the criteria: A. Evidence of memory and learning decline, and at least one other cognitive domain B. Gradual, but steadily progressive decline in cognition, w/out any extended plateaus C. No evidence of mixed etiology.

hypermetamorphosis

Feeling the need to touch everything in sight.

What are the manifestations for Moderate Stage of Alzheimer's Disease

Forgetting events or personal history, being withdrawn or labile (moody), having trouble recalling information, being confused about location or time, needing help dressing appropriately for the occasion or season, experiencing disrupted sleep patterns, having a tendency to wander or become lost, demonstrating behavioral changes, and losing bowel/bladder control.

respite care

Giving family member relief while client is supervised by a professional caregiver.

an infection acquired after diagnosis of (HIV). Client develops neurocognitive disorders related to the infection. As the HIV infection worsens or improves, the impairment may worsen or improve as well.

HIV Infection Dementia

What is the etiology of Huntington's disease dementia?

HTT gene located on chromosome 4

A nurse is planning a music therapy activity for a group of clients who have dementia. What is the purpose for this activity?

Improve appetite Music therapy is effective in improving appetite as well as decreasing depression in clients who have dementia. Music therapy does not Improve social skills, Increase physical activity, or Improve speech

What manifestations should a nurse expect from a client w/ Huntington's disease dementia?

Impulsive behaviors The nurse should expect a client who has Huntington's disease dementia to exhibit impulsive behaviors. Other manifestations can include dysarthria, impaired gait, and irritability.

apraxia

Inability to perform motor activities even though physical ability remains intact.

agraphia

Inability to read or write.

agnosia

Inability to recognize objects, even though sensory ability is intact.

aphasia

Inability to remember or use words correctly.

ataxia

Lack of balance, coordination, and clear speech.

Disorder is marked by the presence of Lewy bodies in the brain. Core diagnostic features include fluctuating cognition, recurrent visual or tactile hallucinations, and spontaneous features of​​​​​​​ parkinsonism (A-synuclein-associated abnormal aggregates of protein)

Lewy Body Disease Dementia (Like Alzheimer's disease, but always ends in severe dementia and death.)

What are the manifestations of Traumatic Brain Injury Dementia

Loss of consciousness, posttraumatic amnesia, disorientation, and confusion, typically occurring immediately after an injury/recovery from injury and persisting past the acute post-injury period.​​​​​ Because a traumatic brain injury can occur at any time in an individual's life span, this diagnosis is seen in all ages

A nurse is selecting a dietary plan for a client who has a family history of Alzheimer's disease. What diet would promote the client's cognitive function?

MIND diet The nurse should identify that the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet is effective in promoting cognitive function.

Medications for Alzheimer's disease

Mild-Moderate: Cholinesterase inhibitors (Donepezil (Aricept), tacrine (Cognex), rivastigmine (Exelon), and galantamine (Razadyne)) Moderate- severe: IV- Methyl-D-Aspartate Antagonist Memantine (Namenda), Namzaric (Combination of memantine hydrochloride extended release and donepezil hydrochloride))

What resources will Nurses offer to caregivers of family members/ friends in the Severe Stage of Alzheimer's Disease?

Palliative care resources and respite care resources

Ways to test executive function

Planning, Decision-making, Responding to feedback, working memory, mental flexibility, Overriding habits

Explain "Planning, Decision-making, and Responding to feedback" for ways to test executive function

Planning: Ability to interpret a sequential picture or object arrangement/find exit. Decision-making: Tasks that involve deciding between alternatives. Responding to feedback: Infer rules from solving a problem.

A nurse suspects a client might have Alzheimer's disease. What type of scan would the provider prescribe to confirm this diagnosis?

Positron emission tomography (PET) scan can be used to detect amyloid plaques, which are present in Alzheimer's disease.

hyperorality

Putting everything in the mouth.

Delirium Tremens (the DTs)

Rapid onset of irritability, confusion, tremors, nausea, vomiting, and seizures caused by withdrawal from substances.

stereotyped behavior

Repeated behaviors without any purpose or function.

During what stage of Alzheimer's Disease will the client will lose awareness of recent experiences, physical challenges, communication problems, be vulnerable to infections, and need help with activities of daily living?

Severe Stage of Alzheimer's Disease

palliative care

Specialized medical care focused on comfort and reduction of symptoms for individuals with a serious or life-threatening illness.

Ways to test complex attention

Sustained attention: Press button when tone heard Divided attention: Tapping while listening to story Selective attention: Count letters while hearing numbers and letters read aloud Processing speed: Time on task

When is the best time for a Alzheimer's client to make end of life choices?

The Mild Stage of Alzheimer's Disease is the best time to make end-of-life legal choices, as the client is usually able to think through decisions in this stage.

Alzheimer's disease is related to the accumulation of amyloid plaques outside and between neurons and tangles within the cells. Olfactory deficits can also be predictive of Alzheimer's disease. What is the survival year rate?

The mean duration of survival after diagnosis is approximately 10 years.​​​​​​​

reminiscence therapy

Therapy used to find meaning by processing memories.

Can a brain injury lead to Huntington's disease?

There is no correlation of Huntington's disease dementia and a previous brain injury.

During what stage of Alzheimer's disease is agraphia, hypermetamorphosis and hyperorality common?

This is common in the Severe Stage of Alzheimer's Disease

confabulate

To create fabricated or distorted memories.

perseverate

To make repetitive verbalizations or motions due to cognitive disturbances.

Type of dementia that occurs after a brain injury.

Traumatic Brain Injury Dementia

parkinsonism

Tremor, rigidity, bradykinesia, and postural instability.

What findings should a nurse expect while caring for a client w/ delirium?

Tremors The nurse should expect a client who has delirium to exhibit manifestations of tremors, tachycardia, confusion, sweating, hyperactivity, and hallucinations.

It is the second most common cause of neurocognitive disorder after Alzheimer's disease caused by decreased blood flow to the brain

Vascular Disease Dementia Vascular neurocognitive disorder has an etiology of deficits with blood vessels

What is 1 cause Delirium

Vitamin deficiencies The nurse should identify a vitamin deficiency such as B12 can cause delirium. Other causes of delirium can include thyroid disorder, head trauma, physical stressors, along with adverse effects of antidepressants and antipsychotic medications.

Explain "working memory, mental flexibility, and overriding habits" for ways to test executive function

Working memory: Adding up a list of numbers Mental flexibility: Shift between 2 tasks, concepts, or response rules (numbers to letter, verbal to keypress, etc.) Overriding habits: Ability to name the color of a word's font, rather than the word.

sundowning

Worsening manifestations in the evening.

Substance/Medication Use Dementia

a disorder with manifestations that go beyond the usual duration of intoxication and acute withdrawal from a substance capable of producing a long-term neurocognitive impairment.

What substances can lead to delirium?

alcohol, cannabis, phencyclidine, hallucinogens, inhalants, opioids, sedatives/hypnotics/anxiolytics, amphetamines, and cocaine.​​​​​​​ Additionally, when a client uses a substance for a prolonged period of time and then withdraws from the substance, the withdrawal can lead to delirium.

Frequently used substances that cause dementia

alcohol, inhalants, opioids, sedatives, hypnotics, anxiolytics, amphetamines / stimulants and cocaine.​​​​​​​

What is the difference between Lewy body disease and Parkinson's disease

clients who have Parkinson's disease have pathology primarily in the basal ganglia, and with Lewy body disease, cognitive decline precedes motor manifestations by at least a year.

What are some causes of Delirium

hepatic encephalopathy, alcohol, metabolic disorders (thyroid disorders), neurological disorders (head trauma), tumors, vitamin B-12 deficiencies, physical stressors (pain or sleep deprivation), and drugs like lithium, levodopa, tricyclic antidepressants, benzodiazepines, central nervous system depressants, digitalis, and steroids.

What symptoms are common for a client who has been diagnosed with Huntington's disease dementia?

involuntary jerking motions also known as chorea.

What are Manifestations of delirium?

irritability, confusion, hyperactivity, trembling, tachycardia, sweating, tremors, nausea/vomiting, impaired consciousness, seizures, and hallucinations (visual, auditory, tactile). However, delirium tremens (DTs) can lead to death if an intervention (benzodiazepines, barbiturates, antipsychotics) is not implemented.

Deficits of language performance at the mild stage of Alzheimer's disease, Clients with Alzheimers may create new, nonsensical words known as

neologisms

What kind of dementia does eating Consuming contaminated beef cause?

prion disease dementia

hat kind of problems can methamphetamine cause?

problems with learning, memory, executive function, and vascular injury.

What are some experiences clients in the Moderate Stage of Alzheimer's Disease may go through

sundowning perseverate confabulate, aphasia, apraxia, or Agnosia. The nurse should make sure the client is safe and supported.