Cognition overview

Types of deficits

Aphasia ( difficulty speaking) Apraxia ( cant take care of themselves) Agnosia ( cant recognize familiar objects) Disturbance of executive function ( can not make decisions)

Focal cognitive disorders

affect a single area of cognitive function (language, memory, visuospatial ability, or executive function). Can lead to impaired social and occupational function

learning disabilities

disorders found in children of normal intelligence who have difficulties in learning specific skills such as processing language or grasping mathematical concepts

Piaget's stages of cognitive development

1. sensorimotor 2. preoperational 3. concrete operational 4. formal operational

The home health nurse is consulting with a family about making changes in their home in order to create a safe environment for a person who has Alzheimer's disease. What is the most important information for the nurse to provide? Select all that apply. 1.Keep all household cleaning products in a locked cabinet. 2.Supervise the client when cooking or fixing a snack. 3.Place all matches and cigarette lighters in a safe place. 4.Install locks on places where garden equipment is kept. 5.Monitor the use of stoves, ovens, and heating appliances. 6.Mount heat sensors or smoke detectors in each room.

1.Keep all household cleaning products in a locked cabinet. 2.Supervise the client when cooking or fixing a snack. 3.Place all matches and cigarette lighters in a safe place. 4.Install locks on places where garden equipment is kept. 5.Monitor the use of stoves, ovens, and heating appliances.

The nurse administered haloperidol (Haldol) to a client with dementia who was experiencing severe agitation. It is most important for the nurse to assess the client for which adverse effects? Select all that apply. 1.Photosensitivity 2.Bradycardia, apnea, and hypotension 3.Urinary output 4.Skin irritations 5.Insomnia, nightmares, and early morning awakenings 6.Dizziness

1.Photosensitivity 3.Urinary output 6.Dizziness

A nurse is caring for a client with delirium. Which nursing intervention has the highest priority? 1.Providing a safe environment. 2.Offering recreational activities. 3.Providing a structured environment. 4.Instituting measures to promote sleep.

1.Providing a safe environment.

The nurse is explaining the symptoms of dementia to military family member who has not seen his mother in 15 months. Which characteristics of dementia of Alzheimer's type would the nurse address in her teaching session? Select all that apply. 1.Experiences an impending sense of doom. 2.Forgets that food is cooking on the stove. 3.Becomes lost walking on her own street. 4.Begins to fear using public transportation. 5.Unable to understand new information

2.Forgets that food is cooking on the stove. 3.Becomes lost walking on her own street. 4.Begins to fear using public transportation. 5.Unable to understand new information

Life expectancy is

20 years less for schizophrenics patients (you can develop heart disease for not resting)

Parkinson's disease

A disorder of the central nervous system that affects movement, often including tremors.

Lewy body dementia

A form of dementia characterized by an increase in Lewy body cells in the brain. Symptoms include visual hallucinations, momentary loss of attention, falling, and fainting.

metabolic syndrome

A syndrome marked by the presence of usually three or more of a group of factors (as high blood pressure, abdominal obesity, high triglyceride levels, low HDL levels, and high fasting levels of blood sugar) that are linked to increased risk of cardiovascular disease and Type 2 diabetes.

Exelon (rivastigmine)

Alzheimer's disease

Namenda (memantine)

Alzheimer's disease

Types of Dementia

Alzheimer's Disease Vascular Dementia Lewy Body Dementia Frontotemporal Dementia

Aricept (donepezil)

Alzheimer's disease

Halidol (haloperidol)

Antipsychotic

Risperidone (Risperdal)

Antipsychotic (Atypical)

Ativan (lorazepam)

Benzodiazepine

During a conversation with a client the nurse observes that the client shifts from one topic to the next on a regular basis. Which disorder is the client most likely experiencing? A. Flight of ideas B. Concrete Thinking C. Word Salad D. Loose Associations

D. Loose Associations

Intellectual Disabilities

Deficits in intellectual functioning and in adaptive functioning that begin during childhood or adolescence IQ score of <70 Three levels Mild IQ 55-70 Moderate IQ 40-55 Severe IQ 25-40 Profound IQ <25

Dementia vs. Alzheimer's

Dementia is a general term for a decline in mental ability severe enough to interfere with daily life. Alzheimer's is the most common cause of dementia. Alzheimer's is a specific disease. Dementia is not.

Huntington's disease

Genetic disorder that causes progressive deterioration of brain cells. caused by a dominant allele. symptoms do not appear until about the age of 30.

Delusions

Persecutory (thinking someone is after you) Referential (think of hidden meanings) Somatic Religious (think they are higher) Grandiose (think highly of themselves) Nihilistic (explosion is gonna happen) Magical thinking ( you have powers) Erotomaniac (believe someone is in love with you)

Stages of Alzheimer's Disease

Stage 1. No apparent symptoms Stage 2. Forgetfulness Stage 3. Mild cognitive decline Stage 4. Mild-to-moderate cognitive decline Stage 5. Moderate cognitive decline Stage 6. Moderate-to-severe cognitive decline Stage 7. Severe cognitive decline

Schizophrenia

a psychological disorder characterized by delusions, hallucinations, disorganized speech, and/or diminished, inappropriate emotional expression Psychosis state of being when positive symptoms are present Men 18-25 woman 25-35

neurocognitive disorders

acquired (not lifelong) disorders marked by cognitive deficits; often related to Alzheimer's disease, brain injury or disease, or substance abuse. In older adults neurocognitive disorders were formerly called dementia

cognition

all the mental activities associated with thinking, knowing, remembering, and communicating

haladol (haloperidol)

antipsychotic

Olanzapine (Zyprexa)

atypical antipsychotic

delirum vs dementia

delirium occurs abruptly and fluctuate through the day where as dementia disrupts your ADL, and memory changes. Delirium is reversible and it is a medical emergency

issues with people with dementia for pharmacotherapy

forget to take medication and polypharmacy (getting refills at multiple pharmacies)

vascular dementia

form of dementia caused by a stroke or other restriction of the flow of blood to the brain

Assessment

in infant and children its determined by achieved milestones in adults its assessed by consciousness, speech pattern, memory and logic

cognitive impairment or intellectual loss

is not part of the aging process

cognitive impairment

loss of ability to think logically; concentration and memory are affected

Catatonia Schizophrenia

may remain motionless for hours on end and then become agitated Stupor: Stupor is a state where a person is unresponsive and seems to be in a deep, almost unconscious sleep. They may be difficult to awaken and show little to no awareness of their surroundings. Catalepsy: Catalepsy is a condition where a person's muscles become rigid and stiff, and they hold fixed poses or positions for extended periods of time, often in response to external stimuli. Waxy Flexibility: Waxy flexibility is a condition in which a person's limbs can be easily moved and positioned by another person, almost like they have soft, pliable wax for muscles. The person may not resist or assist in the movement. Posturing: Posturing refers to the involuntary adoption of unusual or rigid body positions. It can be a symptom of certain neurological or psychiatric disorders. Negativism: Negativism is when a person displays resistance or opposition to suggestions, requests, or even movements made by others. They may do the opposite of what is asked or refuse to cooperate. Mutism: Mutism is a condition where a person remains silent and does not speak, even though they are physically capable of doing so. It's often associated with extreme anxiety or certain neurological conditions. Echopraxia: Echopraxia is the automatic and involuntary imitation of another person's actions or movements. It's like mimicking what someone else is doing without consciously choosing to do so.

delirium

mental disorder marked by confusion

Invega

paliperidone Schizophrenia

positive vs negative symptoms of schizophrenia

positive: additional functions or thoughts (i.e. hallucinations, delusions, mania) negative: lack of function (i.e. apathy, lack of emotion, poor social functioning)

If you're parent has schizophrenia

your child is 10 times more likely to have it

disorganized thinking

ØLoose associations (keeps on switching topics) ØTangentiality (go off on tangents) ØWord Salad (incoherent sentences) ØClang Associations (rhyming) ØCircumstantiality (can not get to end goal of convo) ØNeologisms ( means something only to them) ØEcholalia (mimicking) ØFlight of ideas ØAmbivalence ( cant make decision, mixed emotions)

Epidemiology of Alzheimer's Disease

• Most common cause of dementia -Accounts for 50-75% of all dementia cases, and 60-80% of cases in the elderly • Twice as common in women compared to men • Sixth leading cause of death in the US