Neurodegenerative Dementia

A patient is concerned by recent occurrences of "forgetfulness" that have interfered with both work and social interactions. Which questions should the nurse ask to elicit the most information from the patient? Select all that apply. "Can you multiply 105 by 71?" "Which social activities do you enjoy?" "Do you have a history of heart disease?" "How are you managing your forgetfulness?" "Are you taking any medications that help you with your forgetfulness?"

"Which social activities do you enjoy?" Asking a question about social activities can provide information about whether or not the patient has been withdrawn. This will give important subjective information about the cause and severity of the patient's symptoms. "How are you managing your forgetfulness?" Asking a question about how the patient copes or deals with stressful situations, such as forgetfulness interfering with work and social interactions, can provide important subjective information about the cause and severity of the patient's symptoms. "Are you taking any medications that help you with your forgetfulness?" Asking a question about medication use and whether it has decreased the symptoms can provide important subjective information about the cause and severity of the patient's symptoms.

Match the appropriate pharmacological therapy to the dementia symptom it treats. 1. Difficulty identifying family members 2. Inability to find joy in previously enjoyable activities 3. Physical violence or aggression a. Donepezil b. Ciprofloxacin c. Haloperidol d. Sertraline

1. a 2. d 3. c

A patient with progressive dementia is hospitalized for treatment of an infected diabetic foot ulcer. What additional care should this patient receive because of the dementia diagnosis? Select all that apply. Constant sedation Additional nutritional support Additional emotional support More frequent monitoring and supervision Frequent reorientation and review of the plan of care

Additional emotional support Patients with dementia require reassurance to decrease anxiety, which may manifest as behavioral problems. More frequent monitoring and supervision Patients in the later stages of dementia need to be observed more closely because of concerns about safety. Frequent reorientation and review of the plan of care Patients will most frequently be oriented to time and place, as well as the medical situation and any planned procedures.

examples of neurodegenerative diseases

Alzheimers Dementia Down syndrome parksinsons

The nurse understands that which abnormalities are responsible for the development of Alzheimer's disease? Select all that apply. Abscesses Meningiomas Atrophied tissue Amyloid plaques Neurofibrillary tangles

Amyloid plaques Deposits of β-amyloid protein are characteristic findings in Alzheimer's disease and thought to contribute to the cognitive manifestations. Neurofibrillary tangles Neurofibrillary tangles, or abnormal collections of twisted protein threads, are characteristic findings in Alzheimer's disease and thought to contribute to the cognitive manifestations.

When caring for patients with dementia, the nurse is aware that which neurodegenerative dementia may be mistaken for both Alzheimer's disease and Parkinson's disease? Creutzfeldt-Jacob disease Frontotemporal dementia Dementia with Lewy bodies Amyotrophic lateral sclerosis

Dementia with Lewy bodies Dementia with Lewy bodies presents with symptoms of both Alzheimer's disease and Parkinson's disease. Therefore it is possible for this condition to be mistaken for either of these diseases if a thorough assessment is not performed.

Which disease or condition is most commonly mistaken for dementia? Stroke Depression Dehydration Urinary tract infection

Depression Severe depression can often mimic dementia such that the two conditions can be mistaken for one another.

A patient with Alzheimer's disease reports concern over his mental status, specifically an inability to recall the names of common objects around the house. Additionally, the patient's spouse indicates that the patient will periodically lose his way within the house they have shared for over 40 years. Which medications would the nurse expect to administer to this patient? Select all that apply. Risperidone Donepezil Trazodone Memantine Zolpidem

Donepezil Donepezil is a cholinesterase inhibitor that is used to treat memory and cognition symptoms in patients with Alzheimer's disease. Memantine Memantine is an N-methyl-D-aspartate (NMDA) receptor antagonist that is used to treat memory and cognition symptoms in patients with Alzheimer's disease.

A patient with dementia is being discharged from the hospital. Which points should the nurse include in a discharge plan for the caregiver? Select all that apply. Ensure that windows are locked. Install handrails in the bathroom. Ensure that emergency numbers are on speed-dial. Provide information on new security systems for the patient's home. Rearrange the living area so that patient does not need to use stairs.

Ensure that windows are locked. The patient with dementia is at risk for falls, especially as the disease progresses. Ensuring that windows are locked, especially on the higher floors, can minimize this risk. Install handrails in the bathroom. The patient with dementia is at risk for falling. Installing handrails in the bathroom may minimize this risk. Ensure that emergency numbers are on speed-dial. Although the patient with later stages of dementia may not be able to use a phone, ensuring easy access to help is crucial for patients with dementia who are living at home. Rearrange the living area so that patient does not need to use stairs. Stairs represent a fall risk for the patient with dementia. Stairwells should be well lit if used. However, avoiding stairs altogether will minimize the risk.

How is the onset of neurodegenerative dementia commonly described? Acute Abrupt Gradual Stepwise

Gradual Neurodegenerative dementia is often described as gradual and progressive, with symptoms developing slowly over time.

A patient with dementia has been acting agitated and has started hitting health care staff who interact with him. Which medication may be helpful for this patient? Memantine Mirtazapine Haloperidol Galantamine

Haloperidol Haloperidol, an antipsychotic, is appropriate in very small doses for acute agitation and is used to manage behavioral problems in patients with dementia.

A patient is newly diagnosed with dementia after several months of progressive cognitive decline. The patient is prescribed medication to aid in memory and is still able to perform light duty at work. Which intervention is indicated to counteract the decline in cognitive function? Providing daily eldercare Hanging calendars on the wall Referring the patient for intensive speech therapy Administering antidepressant medication

Hanging calendars on the wall Providing calendars or using sticky notes to aid memory is often a successful approach to managing cognitive decline and memory loss. The nurse should give the patient and caregivers this information and assist if necessary.

An older adult patient is found wandering the streets and is brought to the emergency department. The patient cannot recall her name or where she lives and is admitted to the hospital for observation. She periodically has crying fits and calls out for her mother. What are the nurse's best actions? Select all that apply. Look the patient in the eyes. Redirect the patient to another activity. Provide the patient with easy tasks, one at a time. Be sure to speak loudly so that the patient can hear. Explain to the patient that her mother died several years ago. Speak in a high-pitched voice, saying "Calm down sweetheart."

Look the patient in the eyes. The nurse should use direct eye contact when caring for a patient with dementia. Redirect the patient to another activity. Using distraction, changing the subject, and redirecting to another activity are ways to manage a patient with dementia in a respectful manner.

A patient is brought into the clinic by a caregiver who indicates that the patient's behavior has changed progressively over the last few months. The patient is more forgetful and has experienced loss of simple cognitive abilities, resulting in an inability to maintain employment. For which diagnostic studies to confirm dementia would the nurse prepare this patient? Select all that apply. Electroencephalography Neuroimaging Brain biopsy Patient history Cognitive function tests

Neuroimaging Neuroimaging techniques (computed tomography or magnetic resonance imaging) may be performed to rule out some causes of dementia in patients presenting with signs and symptoms consistent with the condition. Patient history A comprehensive medical, neurological, and psychological history is important in determining the presence and cause of dementia. Cognitive function tests Dementia is often diagnosed when two or more brain functions, such as memory loss or language skills, are significantly impaired.

Which type of dementia may be caused by a sharp blow to the head during a football game? Mixed dementia Creutzfeldt-Jakob disease Dementia with Lewy bodies Normal pressure hydrocephalus

Normal pressure hydrocephalus Normal pressure hydrocephalus is caused by obstruction in the flow of cerebrospinal fluid (CSF), leading to a buildup of CSF in the brain. This type of obstruction may be caused by a head injury.

Which intervention is appropriate for a patient who experiences worsening agitation in the late afternoon or evening? Play soft music during the evening. Provide strong coffee in the morning. Dim lights and avoid talking to the patient. Record and replay a favorite morning talk show at night.

Play soft music during the evening. Creating a quiet, calm environment is crucial to minimizing agitation, especially that which worsens at night.

A patient has experienced progressive memory loss and cognitive dysfunction for 10 years. The patient's caregiver reports the patient is currently experiencing acute agitation and confusion. What is the nurse's priority of care? Protection from harm Reversal of symptoms Management of medication Caregiver education for ambulatory care

Protection from harm A priority of nursing care for the patient with dementia is safety, especially if the patient is agitated and may harm him/herself or others. Patient safety should also be a priority of caregiver education.

A patient is brought into the clinic by a caregiver who reports that the patient has been experiencing confusion and progressive loss of memory and has been using poor judgment. On assessment, the patient appears unshaven and unwashed and smells of urine. What documented sign would the nurse recognize as an indicator of late-stage dementia? Depression Memory loss Soiled clothing Loss of judgment

Soiled clothing The patient's soiled clothing suggests an inability to care for him/herself and is associated with later stages of dementia.

A 74-year-old man presents to occupational therapy with his caregiver. His caregiver has been concerned because the patient, a former engineer, is having trouble doing simple addition problems. The patient has also been wearing thick jackets, despite the summer heat. What are appropriate nursing goals for this patient? Select all that apply. The caregiver will be referred to a support group. The patient will dress appropriately for the season. The patient's symptoms will not progress beyond the current stage. The patient will be able to perform complex mathematical problems. The caregiver will be taught to manage the patient's symptoms alone.

The caregiver will be referred to a support group. The care of patients with Alzheimer's disease includes offering support for the caregivers. This is especially important during the later stages of the disease. The patient will dress appropriately for the season. A primary goal for patients with advancing stages of Alzheimer's disease is to control the undesirable behavior that the patient exhibits, including inappropriate dress.