Term
| What does Cognition refer to? |
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Definition
| Refers to mental process such as comprehension, judgment, memory, language and reasoning |
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Term
| When is Cognitive Impairment Disorder (CID) diagnosed? |
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Definition
| When there is a clinically significant deficit in cognition and a change in a person's previous level of function. |
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Term
| Is cognitive impairment reversible? |
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Definition
| Can be irreversible or fully reversible. Depending on the cause. |
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Term
| What are the 3 types of cognitive impairment disorders? |
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Definition
| Dementia, Delirium, Amnestic Disorders |
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Term
| What is the first step of assessing for CID? |
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Definition
| History & Physical to provide baseline data. |
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Term
| What diagnostic Testing tool is used for assessing CID? |
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Definition
| Mini-mental status exam (MMSE) |
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Term
| What is important to rule out for CID? What tool is used for that? |
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Definition
| Important to rule out depression as patients are in the early stages of dementia sometimes present with symptoms similar to depression. Tool used is Geriatric Depression Scale. |
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Term
| What else is important when assessing for CID? |
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Definition
| Interview pt, caregiviver, family. Spend time w. caregiver or family. |
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Term
| What are the 6 subcategories of DSM-IV Classification of Dementia? |
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Definition
| Dementia of Alzheimer's Type, Vascular Dementia, Dementia due to Other General Medical Conditions, Substance-induced persisting Dementia, Dementia due to Multiple Etiologies, Dementia Not otherwise specified. |
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Term
| What is Dementia of Alzheimer's Type? |
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Definition
| Usually occurs in persons over 65. Manifests progressive intellectual disorientations of dementia, delusions, or depression |
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Term
| What is Vascular Dementia? Also known as? |
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Definition
| Caused by vessel thrombosis or hemorrhage. Also known as multi-infarct dementia. |
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Term
| What id dementia due to other general medical conditions? |
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Definition
| HIV infections, traumatic brain injury, Parkinson's, Huntington's, Pick's, Greutzfeldt-Jakob, normal-pressure hydrocephalus, hypothyroidism, brain tumor, vitamin B-12 deficiency. |
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Term
| What are 2 subtypes of Alzheimer's Dementia? |
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Definition
| Early Onset prior to 65. Late Onset after 65 |
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Term
| What is the Etiology of Alzheimer's Dementia? |
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Definition
| Exact cause unknown. Factors include beta-amyloid plaques, neurofibrillary tangles, cell death, reduction in neurotrasmitters, genetic factors. |
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Term
| What are Beta-amyloid Plaques? |
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Definition
| Accumulation of beta-amyloid forms plaques |
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Term
| What are Neurofibrillary Tangles? |
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Definition
| Disrupt normal intracellular transport and result in cell death |
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Term
| What is the Neurotransmitter Theory? |
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Definition
| Decrease in neurotransmission of acetylcholine; dopamine, norepinephrine, serotonin |
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Term
| What are Genetic Factors for Alzheimer's? |
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Definition
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Term
| Oxidative Stress, Free Radicals and Mitochondrial Dysfunction |
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Definition
| Mitochondrial damage-->Increase in free radicals-->Oxidative Stress |
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Term
| Inflammation for Alzheimer's? |
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Definition
| Inflammation in brain is early hallmark |
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Term
| What is the main difference between Vascular Dementia and Alzheimer's dementia? |
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Definition
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Term
| What is the primary age of patients with Vascular Dementia? |
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Definition
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Term
| What are the causes of Vascular Dementia? |
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Definition
| Series of small strokes, or transient ischemic attacks. Other factors include advanced age, diabetes, heart disease, high cholesterol, hypertension, TIA's , cerebral emboli, thrombosis |
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Term
| What are the Symptoms of Dementia? |
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Definition
| Memory loss, disorientation of time and place, Apraxia, Agnosia, Confabulation, Sundown Syndrome, Catastrophic Reaction, Perseveration Phenomenon, Hyperorality, Psychosis |
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Term
| What is Aphasia? Expressive? Receptive? Global? |
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Definition
| Alterations or loss of language ability. Expressive (speaking or writing), Receptive (understanding), global (usually more severe) |
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Term
| Define Apraxia. How do we test this? |
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Definition
| Impaired ability to carry out motor activities. MMSE we write a command on a piece of paper, have the pt read it and then do what it says |
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Term
| Define Agnosia. How do we test this? |
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Definition
| When the pt is unable to name common objects. MMSE hold up a watch and a pen or pencil and ask the pt to name them |
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Term
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Definition
| When a pt (unconciously) fills memory gaps with detailed fantasy that he or she believes is true but actually has no basis in fact. |
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Term
| What is Sundown Syndrome? |
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Definition
| Describe nighttime disorientation. Characterized by drowsiness, confusion, ataxia, and accidental falls |
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Term
| What is Catastrophic Reaction? |
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Definition
| Agitation that occurs secondary to the awareness of one's intellectual deficits under stressful circumstances. Can show verbal or physical aggression |
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Term
| What is Perseveration Phenomenon? |
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Definition
| Repetitive behaviors such as lip licking, finger tapping, pacing or echolalia |
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Term
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Definition
| Pt has ned to taste and chew objects that are small enough to be put into his or her mouth |
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Term
| Describe psychosis for Alzheimer's dementia |
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Definition
| Early stages they are hyper alert to compensate for cognitive loss. They are more suspicious. Later stages of AD, psychosis in form of hallucinations or delusions. |
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Term
| What are the 4 main medications given for Dementia? |
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Definition
| Cholinesterase Inhibitors, NMDA Blocker, Antipschotics, Antidepressants, Benzodiazepines |
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Term
| How do Cholinesterase Inhibitors work? Popular drugs used? |
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Definition
| Increase levels of acetylcholine, the neurotransmitter involved in memory, judgment and other thought process. Aricept, Exelon, Razadyne, Cognex |
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Term
| What do NMD Aspartic BLockers do? which is a popular drug? |
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Definition
| Restore neuron function. Namenda (memantine). |
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Term
| What other drugs are used to treat Dementia? |
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Definition
| Antipsychotics. Antidepressants. And SSRIs may helpwith insomnia or reduced appetite? Benzodiazepines could be used to treat anxiety. Benzos may also caus paradoxical effect and increase anxiety. |
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Term
| What are Nursing Interventions for Dementia? |
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Definition
| Protect pt from injury, danger, monitor food and fluid intake, regular exercise, regular medical visits, speak in calm manner, minimize confusion, outdoor activities, increase social interaction, support and educate caregivers |
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Term
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Definition
| An acute disorder characterized by short term confusion, disorientation and changes in cognition |
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Term
| What are the 3 criterias for Delirium in DSM-IV language? |
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Definition
| A) disturbance of consciousness with reduced ability to focus, sustain or shift attention B) a change in cognition (memory deficit, disorientation, language disturbance) or development of perceptual disturbance. C) Develops over a short period of time. |
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Term
| What are the classifications of Delirium? |
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Definition
| Delirium Due to general medical conditions, substance-induced Delirium, Substance Withdrawal Delirium, Delirium due to multiple Etiologies, Delirium not otherwise specified |
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Term
| What are the causes of Delirium? |
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Definition
| Acute or Chronic Illness, Hormonal or Nutritional Factors, Sensory Impairments, Medication. |
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Term
| What is the hallmark of delirium? |
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Definition
| Impaired conciousness. Impairment of cognitive functioning that develop rapidly over a short period of time. |
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Term
| What are some psychomotor impairments associated with delirium? |
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Definition
| tremor or problems with coordination |
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Term
| What are the attention and wakefulness disturbances associated with delirium? |
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Definition
| Difficulty with alertness and direction of focus. Have reduced daytime wakefulness and nightime restlessness/sleeplessness. |
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Term
| What is associated with Management of Delirium? |
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Definition
| ID, treat underlying cause, supportive physiologic care, promote safety, acute hospital-based care |
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