WCU NSG 312 (Exam 2)
Alzheimer's Disease - ✔️✔️- Most common form of irreversible dementia
- Between 40-60 % of all dementias are Alzheimer's
- Over 5.2 million Americans have Alzheimer's
- It is estimated that 60% of all nursing home residents have Alzheimer's disease
- Typically death occurs in 4-8 years (called the long goodbye)
- Alzheimer's is not normal aging
- Learning new information make take longer
- May be difficult to filter out noise
Alzheimer's pathphysiology - ✔️✔️- Neurofibrillary tangles obstructing cells
- Beta-amyloid neuritic plaques (dying and dead nerve cells)
- Which decrease neurotransmitters
- Communication between cells is BLOCKED
What is Dementia - ✔️✔️- Disease Process
- Progressive decline in cognitive function
- Memory loss
How many irreversible dementias are there - ✔️✔️- Over 170
- Vascular, Lewy Body, Parkinson's, Alzheimer's
- Alzheimer's accounts for 40-60 percent (diagnosed by autopsy)
Risk factors for dementia - ✔️✔️- Age > 60 years old
- Family history
- First degree relative more likely
- Diabetes
- Obesity
- Smoking
- Cardiac dysrhythmias
- Hypertension **
- CAD
- African American 2x more likely
- Hispanics 1 ½ x more likely
Disease Progression of Alzheimer's - ✔️✔️- Forgetfulness
- Language
- Short-term memory
- Agnosia (inability to recall common things)
- Emotional liability
- Personality changes
- Cognitive skills
,- Loss of social skills
Alzheimers memory loss - ✔️✔️- Frequently misplaces items
- Forgets what an item is used for
- Forgets peoples names
- May not remember knowing a person
- Difficult time finding words
- Lose language skills
- Forgets recent events
- Easily disorients or lost in familiar places
early stages of Alzheimer's disease (I-III) - ✔️✔️- Mild cognitive decline
- needs reminders
- daily routine difficult
- concentration is difficult
middle stages of Alzheimer's disease (IV-V) - ✔️✔️- Obvious memory loss
- May need hands on care
- May get lost easily
- Changes in personality
Late stages of Alzheimer's disease (VI-VII) - ✔️✔️- Inability to care for self
- Severe confusion
- Needs hand on care for most personal care
- May not recognize self or family
Complications related to Alzheimer's - ✔️✔️- Infection
- Pneumonia
- Falls
- Malnutrition
- Dehydration
- Multiple organ failure
Alzheimer's medications - ✔️✔️- donepezil
- rivastigmine
- galantamine
- memantine
Alzheimer's nursing implications - ✔️✔️- Weight & Intake/Output
- Bowel & Bladder function
- Routine toileting practices
- Skin
- ADL support
- Assist with feeding: provide finger foods
- Environmental & Safety
, - Falls! Bed locked & lowest
- Grab bars
- Reduce clutter
- ROUTINES
- Speak calmly and use positive statements
Assessing for Alzheimer's - ✔️✔️- Mini-mental state examination (MMSE)
- Scoring
- 25-30 May have clinically significant but mild deficits. Likely to affect only most
demanding activities of daily living.
- 20-25 Significant effect. May require some supervision, support and assistance.
- 10-20 Clear impairment. May require 24-hour supervision.
- 0-10 Severe Patient not likely to be testable. Marked impairment. Likely to require 24-
hour supervision and assistance with ADL
Delirium - ✔️✔️- Acute onset, can be treated: abrupt
- Altered state of consciousness
Depression - ✔️✔️- Gradual onset, can be treated
- Look for signs, such as low self-esteem, low energy, difficulty sleeping
Dementia - ✔️✔️- Gradual onset, might be treated
- Memory loss and decline in cognitive function
Person centered care - ✔️✔️- Person centered care is truly putting the PERSON first
- Characteristics
- Behaviors are a desire to communicate
- We must maintain and uphold the value of the person
- Promote positive health
- All action is meaningful
Dementia is defined as a
A. Symptom that results only in memory loss
B. Disease associated with abrupt changes in behavior
C. Disease that is always due to reduced blood flow to the brain
D. Syndrome characterized by cognitive dysfunction and loss of memory
E. None of the above - ✔️✔️D. Syndrome characterized by cognitive dysfunction and
loss of memory
Stage I in Alzheimer's Disease is characterized by
A. No noticeable change in behavior
B. Memory problems and mild confusion
C. Increased time spent in bed or sleeping
D. Incontinence, agitation, and wandering behavior
Alzheimer's Disease - ✔️✔️- Most common form of irreversible dementia
- Between 40-60 % of all dementias are Alzheimer's
- Over 5.2 million Americans have Alzheimer's
- It is estimated that 60% of all nursing home residents have Alzheimer's disease
- Typically death occurs in 4-8 years (called the long goodbye)
- Alzheimer's is not normal aging
- Learning new information make take longer
- May be difficult to filter out noise
Alzheimer's pathphysiology - ✔️✔️- Neurofibrillary tangles obstructing cells
- Beta-amyloid neuritic plaques (dying and dead nerve cells)
- Which decrease neurotransmitters
- Communication between cells is BLOCKED
What is Dementia - ✔️✔️- Disease Process
- Progressive decline in cognitive function
- Memory loss
How many irreversible dementias are there - ✔️✔️- Over 170
- Vascular, Lewy Body, Parkinson's, Alzheimer's
- Alzheimer's accounts for 40-60 percent (diagnosed by autopsy)
Risk factors for dementia - ✔️✔️- Age > 60 years old
- Family history
- First degree relative more likely
- Diabetes
- Obesity
- Smoking
- Cardiac dysrhythmias
- Hypertension **
- CAD
- African American 2x more likely
- Hispanics 1 ½ x more likely
Disease Progression of Alzheimer's - ✔️✔️- Forgetfulness
- Language
- Short-term memory
- Agnosia (inability to recall common things)
- Emotional liability
- Personality changes
- Cognitive skills
,- Loss of social skills
Alzheimers memory loss - ✔️✔️- Frequently misplaces items
- Forgets what an item is used for
- Forgets peoples names
- May not remember knowing a person
- Difficult time finding words
- Lose language skills
- Forgets recent events
- Easily disorients or lost in familiar places
early stages of Alzheimer's disease (I-III) - ✔️✔️- Mild cognitive decline
- needs reminders
- daily routine difficult
- concentration is difficult
middle stages of Alzheimer's disease (IV-V) - ✔️✔️- Obvious memory loss
- May need hands on care
- May get lost easily
- Changes in personality
Late stages of Alzheimer's disease (VI-VII) - ✔️✔️- Inability to care for self
- Severe confusion
- Needs hand on care for most personal care
- May not recognize self or family
Complications related to Alzheimer's - ✔️✔️- Infection
- Pneumonia
- Falls
- Malnutrition
- Dehydration
- Multiple organ failure
Alzheimer's medications - ✔️✔️- donepezil
- rivastigmine
- galantamine
- memantine
Alzheimer's nursing implications - ✔️✔️- Weight & Intake/Output
- Bowel & Bladder function
- Routine toileting practices
- Skin
- ADL support
- Assist with feeding: provide finger foods
- Environmental & Safety
, - Falls! Bed locked & lowest
- Grab bars
- Reduce clutter
- ROUTINES
- Speak calmly and use positive statements
Assessing for Alzheimer's - ✔️✔️- Mini-mental state examination (MMSE)
- Scoring
- 25-30 May have clinically significant but mild deficits. Likely to affect only most
demanding activities of daily living.
- 20-25 Significant effect. May require some supervision, support and assistance.
- 10-20 Clear impairment. May require 24-hour supervision.
- 0-10 Severe Patient not likely to be testable. Marked impairment. Likely to require 24-
hour supervision and assistance with ADL
Delirium - ✔️✔️- Acute onset, can be treated: abrupt
- Altered state of consciousness
Depression - ✔️✔️- Gradual onset, can be treated
- Look for signs, such as low self-esteem, low energy, difficulty sleeping
Dementia - ✔️✔️- Gradual onset, might be treated
- Memory loss and decline in cognitive function
Person centered care - ✔️✔️- Person centered care is truly putting the PERSON first
- Characteristics
- Behaviors are a desire to communicate
- We must maintain and uphold the value of the person
- Promote positive health
- All action is meaningful
Dementia is defined as a
A. Symptom that results only in memory loss
B. Disease associated with abrupt changes in behavior
C. Disease that is always due to reduced blood flow to the brain
D. Syndrome characterized by cognitive dysfunction and loss of memory
E. None of the above - ✔️✔️D. Syndrome characterized by cognitive dysfunction and
loss of memory
Stage I in Alzheimer's Disease is characterized by
A. No noticeable change in behavior
B. Memory problems and mild confusion
C. Increased time spent in bed or sleeping
D. Incontinence, agitation, and wandering behavior
