NUR 414A Cognition

The nurse is planning care for a client who displays confusion secondary to a neurological problem. Which approaches by the nurse would be helpful in assisting this client? Select all that apply. 1.Providing sensory cues 2.Giving simple, clear directions 3.Providing a stable environment 4.Keeping family pictures at the bedside 5.Encouraging family members to visit at the same time

1, 2, 3, 4

what is ideomotor apraxia

inability to translate an idea into action

what is agraphia

inability to write

IQ score for moderate intellectual disability

40-55

IQ score for mild intellectual disability

55-70

diagnostics of cognition

-MRI -PET -standardized tests of memory and visuospatial function

risk factors for cognition

-advancing age -personal behaviors -environmental exposures -congenital or genetic conditions -physical disability and reduced mobility -health conditions -women (poor health status, dependency, lack of support, insomnia) -men (hx of stroke or diabetes)

alzheimer's disease meds

-cholinesterase inhibitors (donepezil, rivastigmine, galantamine) -glutamate receptor antagonist (memantine)

common intellectual disabilities

-chromosomal abnormalities -genetic conditions -malnourishment -toxins -cerebral anoxia

categories of cognitive impairment

-delirium -dementia -cognitive impairment -focal cognitive disorders -intellectual disability -learning disability

consequences of cognitive impairment

-higher risk for injury -lack of accurate perception -lack of risk recognition -lack of capacity for appropriate responses to dangerous situations -financial hardship -caregiver burden

3 primary changes of cognition in infants

-increase in brain mass -neuronal-synaptic connections -myelination

what are the 6 domains of cognitive function

-perceptual motor function -language -learning and memory -social cognition -complex attention -executive function

what should you do for agitated pt

-private room -soft music -relaxation tapes -massage

treatment for cognition issues

-promote adequate sleep, rest, fluid intake, nutrition, elimination, pain control, comfort -predictable routines, consistent caregivers -sensory aids -reorient to time and place -safety interventions -specific meds for alzheimers

older adult cognitive changes

-size and weight or brain along with # of neurons decreases with aging -less efficient neurotransmission and slowing of neural responses

An older client in an acute state of disorientation is brought to the hospital emergency department by the client's daughter. The daughter states that the client was "clear as a bell this morning." The nurse determines from this piece of information that which is an unlikely cause of the disorientation? 1.Hypoglycemia 2.Alzheimer's disease 3.Medication dosage error 4.Impaired circulation to the brain

2

The nurse is conducting home visits with a head-injured client with residual cognitive deficits. The client has problems with memory, has a shortened attention span, is easily distracted, and processes information slowly. The nurse plans to talk with the primary health care provider about referring the client to which professional? 1.A psychologist 2.A social worker 3.A neuropsychologist 4.A vocational rehabilitation specialist

3

what is anterograde amnesia

loss of ability to learn and recall new information on an ongoing basis

cognition health promotion

primary - optimal nutrition, exercise, social activity, regular medical care, avoidance secondary - MMSE, CAM, screenings

whats cognition

the mental action or process of acquiring knowledge and understanding through thought, experience and the senses

in the first year of life, how much does the brains weight change

triples itself in weight

IQ score for severe intellectual disability

25-40

The nurse is caring for a client diagnosed with Alzheimer's disease. The nurse should anticipate that the client has changes in which component of the nervous system? 1.Glia 2.Peripheral nerves 3.Neuronal dendrites 4.Monoamine oxidase

3

The nurse is caring for a client with a neurological deficit involving the hippocampus. On assessment of the client, which signs and symptoms would most likely be noted? 1.Disoriented to client, place, and time 2.Affect flat, with periods of emotional lability 3.Cannot recall what was eaten for breakfast today 4.Unable to add and subtract; does not know who is president

3

The nurse is caring for an older adult who has been placed in Buck's extension traction after a hip fracture. On assessment of the client, the nurse notes that the client is disoriented. What is the best nursing action based on this information? 1.Apply restraints to the client. 2.Ask the family to stay with the client. 3.Place a clock and calendar in the client's room. 4.Ask the laboratory to perform electrolyte studies.

3

An older client is brought to the hospital emergency department by a neighbor who heard the client talking and found him wandering in the street at 3 a.m. The nurse should first determine which data about the client? 1.His insurance status 2.Blood toxicology levels 3.Whether he ate his evening meal 4.Whether this is a change in usual level of orientation

4

The nurse is conducting a neurological assessment, including a health history, on a client with a neurological disorder. The nurse observes that the client is having difficulty answering the questions and should perform which action? 1.Ask a second nurse to be present during the interview. 2.Defer both the health history and the neurological examination. 3.Defer the health history and proceed with the neurological examination. 4.Ask the client to give permission for a family member to stay during the interview.

4

IQ score for profound intellectual disability

<25

intellegence level of pts with learning disability

average or above average

what is global aphasia

both language reception and expression impaired

what is aphasia

difficulty with production or comprehension of language or both

assessment of cognition

hx - wakefulness, speech pattern, memory, logic, judgment, family hx exam - posture and body movements, dress and hygiene, A/O, MMSE, impaired cognition, dementia specific

what is anomia

impaired ability to name places or objects may have difficulty with sentence repetition, comprehension and expression intact

what is agnosia

impaired ability to recognize objects or persons through sensory stimuli

what is object agnosia

impaired ability to recognize visual forms

what is retrograde amnesia

impaired ability to retrieve information from the past

what is wernicke's aphasia

impaired comprehension of both written and verbal language, even understanding single words, speech fluent, and person in unaware that words used are incorrect

what is broca's aphasia

impaired language expression characterized by nonfluent, labored speech, comprehension of language intact

what is alexia

impaired reading ability