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RNSG 1443 Neurological and Neurosensory Disorders practice Study Guide

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DEMENTIA 1. Symptoms  Characterized by multiple cognitive deficits that include memory impairment and at least one of the following cognitive disturbances: o Aphasia o Apraxia o Agnosia o Disturbances in executive thinking  The deficits must be severe enough to cause impairment in occupational or social functioning and must represent a decline in the client’s previous level of functioning.  Common symptoms include: o Aphasia: the loss of language ability, speech is often impoverished and the client may have difficulty “finding” the right words o Apraxia: an impaired ability to carry out motor activities despite intact sensory function o Confabulation: filling in memory gaps with detailed fantasy believed by the affected individual o Sundown syndrome: characterized by increased disorientation and confusion at night

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ACENA, JOBELLE C.




Neurological Disorders
Acena, Jobelle C.
Union Christian College

,ACENA, JOBELLE C. 2


Neurological Disorders
DEMENTIA
1. Symptoms
 Characterized by multiple cognitive deficits that include memory impairment and
at least one of the following cognitive disturbances:
o Aphasia
o Apraxia
o Agnosia
o Disturbances in executive thinking
 The deficits must be severe enough to cause impairment in occupational or social
functioning and must represent a decline in the client’s previous level of
functioning.
 Common symptoms include:
o Aphasia: the loss of language ability, speech is often impoverished
and the client may have difficulty “finding” the right words
o Apraxia: an impaired ability to carry out motor activities despite
intact sensory function
o Confabulation: filling in memory gaps with detailed fantasy believed
by the affected individual
o Sundown syndrome: characterized by increased disorientation and
confusion at night
o Perseveration phenomenon: includes repetitive behaviors, including
pacing and echoing other’s words.
o Memory loss
o Disorientation to time, place and person
o Decreased ability to concentrate or to learn new material
o Difficulty making decisions
o Poor judgment

2. Types of Dementia
 Dementia of the Alzheimer’s type: most common form of dementia affecting
elderly clients categorized according to its stages and related symptoms:

Stage Behavior Affect Cognitive changes
Mild  Difficulty completing tasks  Anxious  Recent memory losses
 Decline in goal-directed  Depressed  Time disorientation
activity  Frustrated  Decreased ability to
 Lack of attention to  Suspicious concentrate
personal appearance and  Fearful  Difficulty making
ADL decisions
 Withdrawal from unusual  Poor judgment
social activities
 Frequent searching for

, ACENA, JOBELLE C. 3


misplaced objects; may
accuse others of stealing
Moderate  Socially inappropriate  Labile mood  Recent and remote
behavior  Flat, apathetic memory losses
 Self-care deficits  Agitation (amnesia)
 Wandering and pacing  Paranoia  Confabulation
 Hoarding objects  Disorientation to time,
 Disturbance in sleep-wake place and person
cycle  Some degree of
agnosia, apraxia and
aphasia
Severe  Decreased ability to  Flat, apathetic  Progression of
ambulate or engage in  Occasional cognitive changes,
other motor activities catastrophic with increased
 Decreased swallowing reactions may severity of amnesia,
activity continue agnosia, apraxia, and
 Complete self-care deficits aphasia


 Vascular (multi-infarct) dementia: the second leading cause of dementia in
elderly clients; occurs when blood clots block small blood vessels in the brain and
destroy the brain tissue.
 Other types of dementia associated with general medical conditions: Parkinson’s
disease, Pick’s disease, Huntington’s chorea, Creutzfeldt-Jakob disease and
HIV.

o Pick's disease is a degenerative brain disease that particularly affects the
frontal and temporal lobes and results in a clinical picture similar to that of
Alzheimer's disease. Early signs include personality changes, loss of social
skills and inhibitions, emotional blunting, and language abnormalities.
Onset is most commonly 50 to 60 years of age; death occurs in 2 to 5
years.
o Creutzfeldt-Jakob disease is a central nervous system disorder that
typically develops in adults 40 to 60 years of age. It involves altered
vision, loss of coordination or abnormal movements, and dementia that
usually progresses rapidly (a few months). The cause of the
encephalopathy is an infectious particle resistant to boiling, some
disinfectants (e.g., formalin, alcohol), and ultraviolet radiation. Pressured
autoclaving or bleach can inactivate the particle.
o Parkinson's disease is a slowly progressive neurologic condition
characterized by tremor, rigidity, bradykinesia, and postural instability. It
results from loss of neurons of the basal ganglia. Dementia has been
reported in approximately 20% to 60% of people with Parkinson's disease
and is characterized by cognitive and motor slowing, impaired memory,
and impaired executive functioning.

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