PMHNP ancc Chapter 12 Neurocognitive Exam 2024

PMHNP ancc Chapter 12 Neurocognitive Exam 2024 when do cognitive disorders occur - Answer️️ - any age. the very young and very old often have multiple health needs older adults usually have more than one chronic illness and psy. disorders can be co-morbid etiology of cognitive disorders - Answer️️ - a complex general medical condition resulting in changes in multiple domains including memory, interpersonal relationships, and behavior. can result from injury, medical condition, substance abuse, reaction to a medication, other injected agents or a combination of these Delirium is a - Answer️️ - syndrome, not a disease Subtypes of delirium - Answer️️ - hyperactive, agitated hypoactive, lethargic slowed mixed, cycles between hyperactive and hypoactive etiology of delerium - Answer️️ - general medical condition substance induced physical health problems medication sleep deprived incidence of delirium - Answer️️ - highest in hospitalized older adults 70-87% older adults in ICU 60% of Nursing home residents 25% with cancer 80% terminally ill nearing death 1 year mortality rate of pt with delirium - Answer️️ - 40% risk factors for delerium - Answer️️ - age multisystem medical illness substance abuse vision or hearing impairment past episodes brain disorder or cognitive impairment screening for delirium - Answer️️ - Confusion Assessment Method (CAM) Delirium Index (DI) NEECHAM Confusion Scale Mini-Cog presentation of delrium - Answer️️ - rapid change from baseline, waxs and wanes Key findings for delirium - Answer️️ - disturbance of consciousness develops over a short period of time fluctuates during the day several of day and night is common impaired recent and intermediate memory agitated type -- purposeless, random action resolves in hours to days if sx are discovered and treated sooner, resolves sooner, can last 3-6 months physical exam finding for delirium - Answer️️ - tremors.. poor coordination, urinary incontinence, myoclonus, nystagmus. asterixis (flapping of the wrist), increase muscle tone and reflex mental status exam fiindings for delerium - Answer️️ - disheveled, highly inattentive, speech- impaired, rambling, incoherent, slurring affect- rapid unpredictable changes from lethargic to agitate without precipitation mood-difficult to elicit thought process- disorganized, distractable illusions common, hallucination usually visual and accompanied by illusions disoriented --!st sx to appear memory, judgment, concentration, abstraction all grossly impaired diagnositc work-up for delerium - Answer️️ - serum chemistry, CBC, thyroid function, syphilis, HIV, urinalysis. chest x-ray, UDS EEG Pharmacological Treatment for delerium - Answer️️ - symptomat