Maryville NURS 624 exam 4 questions and answers already passed

Maryville NURS 624 exam 4 questions and answers already passed Delerium onset ACUTE, NEW onset abrupt over short period from hrs to days (possibly weeks) Delirium timing? confusion fluctuates throughout the day causes of delirium? CVA acute medical condition: distsended bladder or constipation sensory deprivation (poor eyesight) fever, infection actively dying adverse rxcn or withdrawal of medication stroke hypoxemia serotonin syndrome thyroid dx S/sx of delerium INATTENTION sleep-wake cycle disturbance memory problems psychomotor retardation agitation perceptual disturbance/hallucinatons language disturbance what is the hallmark sign of delirium? inattention What is a MMSE? What are the 8 categories within it? Mini-mental state examination: USE To INDICATE presence of cognitive impairment (NOT DIAGNOSIS OF DISEASE) 1. what is the year? 2. where are we? 3. name three objects and have pt repeat 4. serial 7's, or spell world backwards 5. ask for the same 3 objects earlier 6. name a pencil and wrist watch repeat "no ifs and or buts" follow a three stage command read and obey: close your eyes, write a sentence, copy design. dementia onset slowly over months to years (deterioration in cognition resultin in behavioral problems and impariment of dialy activities. (a decline in 1 or more than 1 cognitive domaine: memory, language, vision, or frontal executive function) what are possible causes of dementia? alzheimers parkinsons motor neuron disease medications trauma infection s/sx of dementia aphasia apraxia (inability to preform purposeful actions) agnosia (inability to interpret sensations) impairment of occupation or social functioning severe: incontinence, inability to perform ADLs, inability to speak, wt loss what drugs are used for dementia tx? cholinesterase inhibitors antipsychotic drugs: haldol, seroquel, zyprexa, abilify to help dec agitationa nd anxiety S/sx of Alzheimer's Disease slow onset deteriorating physical and mental fxns' -forgetfulness, getting lost, wording finding, behaviroal problems (agitation) sundowning (sxs worse at night) decreased brain VOLUME decreased ACETYCHOLINE NEURFIBRILLARY TANGLES AND SENILE PLAQUES increased glutamate (too much = neurotoxic!) get up and go test MOBILITY SCREEN: Time it takes for a person to rise from an armchair, walk 10 feet, turn, walk back and sit down (Average healthy adult 60 years can do it in 10 seconds) Montreal Cognitive Assessment (MoCA) screening for mild cognitive dysfunction; asess different cognitive domains like attention, visuconstructional, memory, etc. and scored up to 30 points 26 = normal prescribing considerations for Donepezil? used in mild to moderate AD diarrhea, nausea, anorexia and weight loss cholinesterase inhibitor prescribing considerations for Memantine (N-methyl-d-aspartate receptor antagonist) used in moderate to severe AD- can be used with cholinesterase inhibitors contraindicated with renal impairement requires several weeks for efficacy how to read score of MMSE? range 0-30 median score for avg adults is 29 median score for 80 yr and older is 25... scores of AD: 20-25 early stage AD 10-19 middle stage AD 10