NUR 2459 / NUR2459 Final Exam 2 Study Guide | Latest 2023/2024

NUR 2459 / NUR2459 Final Exam 2 Study Guide | Latest 2023/2024. Onset of the symptoms is usually quite abrupt and duration is usually brief (1 week – rarely 1 month) TX: Antipsychotic (low-dose) haloperidol (Haldol) Benzodiazepine (lorazepam or diazepam) B1 IV for thiamine deficiency and electrolyte imbalance. Supplemental oxygen. Decrease stimulation, Have family stay with client, Verbally orient to time, place and situations several times daily, Place in room close to the nursing station. Etc. Dementia: a mental disorder involving functional decline in multiple cognitive areas, including memory along with behavioral and psychological symptoms. Dementias are classified according to the cause or areas of neurological damage. Stages of Alzheimer’s disease o Stage 1- No apparent symptoms o Stage 2- Forgetfulness o Stage 3- Mild cognitive decline o Stage 4- Mild to Moderate cognitive decline ■ confabulation o Stage 5- Moderate cognitive decline o Stage 6- Moderate to severe cognitive decline ■ sundowning o Stage 7- Severe cognitive decline How the brain changes: An overabundance of structures called plaques and tangles appear in the brain of individuals with Alzheimer’s disease. ■ Amyloid Plaques are made of amyloid protein. This clumps together and form between nerve cells causing neuronal destruction. ■ Tangles are formed from a cellular protein called tau protein. Strands of protein become tangled together, interfering with neuron transport. ■ Brain atrophy TX: galantamine (Razadyne)-cholinesterase inhibitor – mild to moderate ■ donepezil (Aricept)-cholinesterase inhibitor-- all stages ■ rivastigmine (Exelon)—all stages ■ memantine (Namenda)—moderate to severe ■ donepezil and memantine (Namzaric)—moderate to severe Symptoms: Confabulation, Preservation, Agraphia, Aphasia, Apraxia, Agnosia, Auditory agnosia, Hyperorality, Hypermetamorphesis ,Sundowning It is important that that what the individual is saying is heard, and that the caregiver listen and understand the frustration shown. Interventions: Orient to time and place. Keep environment safe. Assist the client with ambulation and ADL’s. Remain calm and undemanding and avoid pressing the client when he/she is refusing. Dance and movement therapy. Music (of the client’s past) Care of the client with Substance Misuse, Drug and Alcohol and addictive related psychiatric problems Substance-related and Addictive Disorders: Substance use disorders are complex. Symptoms fall into four groups. o Impaired control o Social impairment o Risk, use o Physical effect It is important for all nurses regardless of practice specialty area to develop an understanding of the complex disease of substance use disorders. Weed: intoxication: impaired motor coord. Euphoria, anxiety, sensation of slowed time, impaired judgement, social withdrawl. Withdrawal: anger, aggression, anxiety, irritability, sleep difficulty, decreased appetite, restlessness, depressed mood, physical symptoms. Opioid: intoxication: psychomotor retardation, Drowsiness, slurred speech, altered mood, impaired memory and attention, Bradycardia, Hypotension, hypothermia, meiosis (pinpoint pupils) , intense drowsiness, coma.