PMHNP - NEUROCOGNITIVE disorders with 100% Verified Solutions | Updated & Verified | 2024

cognitive disorders - deterioration of mental functions due to temporary brain or permanent brain dysfunction deficit in cognition change from previous baseline level of functioning -Delirium -Dementia Medically: change in memery, cognition, behavior or interpersonal relationship causes of cognitive disorders - Causes: injury, medical condition, SUD, rx to meds or other agents delirium - an acutely disturbed state of mind that occurs in fever, intoxication, and other disorders and is characterized by restlessness, illusions, and incoherence of thought and speech. Syndrome NOT a disease short term acute onset most s/s resolve w/in 3 to 6 mo older M more prone than F Subtypes of delirium - hyperactive, hypoactive, mixed Causes of delirium - AEIOU TIPS alcohol/drugs, withdrawlelectrolyte abnormality iatrogenic (anticholinergics, benzodiazepines, antiepileptics, blood pressure medicines, insulin/hypoglycemics, narcotics, steroids, H2 blockers, NSAIDs, antibiotics, oxygen hypoxia (bleeding, central venous, pulmonary) Uremia/hepatic encephalopathy trauma infection poisons seizures prevalence of delirium - Low in the community overall (1 - 2%), but increases with age Common in elder adults In US 0.4% 1-2% - >65yo 10 - 30% in older individuals presenting at emergency Depts.; often indicative of a medical illness 6-56% in hospitalized population 15 - 56% of older individuals postoperatively 70 -87% of older people in intensive care up to 60% of individuals in nursing homes/post-acute care settings 25% - clients w/cancer up to 83% of all individuals at the end of life 1 year mortality rate up to 40%risk factors for delirium - age medical illness substance use visual or hearing impairement past delirium episode Delirium Scale - CAM Confusion Assessment Method Delirium S/S - Disorientation, agitation, irritability, combative, delusions, hallucinations, illusions sundowning Neurologic findings in delirium - tremors incoordination urinary incontinence myoclonus nystagmus asterixis - flapping of hands increased muscle tone LABs - delirium - CBC w/ diff, electrolytes, BUN, Creatinine, VDRL, B12, folate, UA, TSH, calcium, magnesium, phosphorus, glucose, UDS, liver fxn tests, peripheral oxygen sat, CXR, ECG, mental status & Physical exam +HIV, syphilis EEG R/out in delirium - D - drugs E - electrolytes L - low oxygenI- infection R - reduced sensory input I - Intracranial U - urinary or renal retention M - myocardial Delirium in children - especially susceptable if child is not soothed w/parental presence suspect delirium common in febrile stages meds ? - anticholinergics Dementia - An abnormal condition marked by multiple cogn