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Medical-Surgical Nursing (7th Edition) – Comprehensive Study Guide Exam Review

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Medical-Surgical Nursing (7th Edition) – Comprehensive Study Guide Exam Review

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Altered cognitive states are common diagnoses as? delirium or dementia depending on the onset,
duration, contributing factors, response to intervention, and progression. It is possible to have both
dementia and delirium at the same time. << correct answer >>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 and that usually gets resolved when the underlying
problem is corrected. Examples of factors that may cause delirium in the older adult are infection, fever,
and drug effects. << correct answer >>The diagnostic and statistical manual of mental disorders, 5th
edition (DSM-5) is published by the American Psychiatric Association. The DSM-5 provides guidelines for
the diagnosis and classification of mental disorders. << correct answer >>Neurocognitive disorders
(NCDs) Include delirium, as well as major NCDs, mild in NCDs, and their subtypes based on cause. NCDs
exist along a continuum from mild to moderate depending on the severity of impairment. << correct
answer >>Each of the neurocognitive disorders affects one or more domains of cognitive function.
These domains are complex attention, executive function, learning and memory, language,
perceptual-motor function, and social cognition. << correct answer >>Complex attention disorders
Complex attention disorders result in difficulty staying on task and sorting through multiple
stimuli. << correct answer >>Executive function allows people to plan, make decisions, carry out plans,
and evaluate activities. Therefore a person with impaired executive function has difficulty with
multitasking and carrying out multiple steps. << correct answer >>cognitive impairment loss of ability to
think logically; concentration and memory are affected. << correct answer >>altered cognition
Physiologic factor that frequently hinders effective communication. These onsets are commonly
diagnosed as delirium or dementia depending on the onset, duration, contributing factors, response to
interventions, and progression. << correct answer >>altered mental function develops suddenly or
gradually depending on the underlying pathology. << correct answer >>dementia a slowly
progressive decline in mental abilities, including memory, thinking, and judgment, that is often
accompanied by personality changes. Major NCD. << correct answer >>factors that may cause delirium
fever, infection, and drug effects. << correct answer >>neurocognitive disorders acquired (not
lifelong) disorders marked by cognitive deficits; often related to Alzheimer's disease, brain injury or
disease, or substance abuse. In older adults, neurocognitive disorders were formerly called dementia.

Affects one ore more domains of cognitive function. These domains are complex attention, executive
function, learning and memory, language, perceptual-motor function, and social cognition. << correct
answer >>executive function allows people to plan, make decisions, carry out plans, and evaluate
activities. Therefore, a person with impaired executive function has difficulty with multitasking caring
out multiple steps. << correct answer >>perceptual-motor disorders Can affect the ability to perform
usual activities, such as driving a car. << correct answer >>social cognition the processes by which
people come to understand others. Is concerned with recognizing emotions. They may have personality
changes and become insensitive to the feeling of others. These disturbances can be mild or major. <<
correct answer >>altered cognitive states. Are commonly diagnosed as delirium or dementia
depending on the onset, duration, contributing factors, response to intervention, and progression. <<

, correct answer >>examples of factors that may cause delirium in the older adult are? Infection, fever,
and drug effects. << correct answer >>complex attention disorders result in difficulty staying on
task and sorting through multiple stimuli. << correct answer >>learning and memory May affect
short term and long term memory, which can affect all aspects of functioning. A person might forget
appointments, leave food on a hot stove, be unable to dress or shop, or become lost. << correct answer
>>Language disorders Can affect the ability to understand or use words. << correct answer
>>Perceptual-motor dirsorders can affect the ability to perform usual activities, such as driving a car.
Various defects in vision may be present. S << correct answer >>Social cognition is concerned with
recognizing emotions. When social cognition is disturbed, people may say or do socially inappropriate
things. They may have personality changes and become insensitive to the feelings of others. These
disturbances can be mild or major. << correct answer >>Delirium Is a decline from a person's
usual attention and awareness (orientation to the environment). People with delirium may have
difficulty focusing or paying attention; consequently, they are easily distracted. Engaging them in a
conversation may be difficult, and often questions must be repeated. Delirium develops over a short
period of time and tends to vary in severity throughout the day. In addition to altered attention and
awareness, the patient has an additional disturbance such as memory deficit, disorientation, or a
language or perceptual problem. Speech may be slurred and disjointed with aimless repetitions.
Individuals may misinterpret what is happening in the environment and may develop delusional thinking
and experience hallucinations.

Examples are they may think that the banging of a door is a gunshot. A common delusion is that
someone is trying to steal from them. Sleep wake disturbances are common. A delirious person may be
hyperactive, hypoactive, or alternate between the two. The level of consciousness may fluctuate from
drowsiness to stupor or coma. At the other extreme, the individual may be extremely alert and agitated.
<< correct answer >>diagnoses of delirum evidence must exist that the symptoms can be
explained by the medical condition, substance intoxication or withdrawal, exposure to a toxin, or
multiple causes. Example of medical conditions that can cause delirium are infection, liver or kidney
failure, fluid and electrolyte imbalances, and hypoxia. Drugs such as alcohol, opioids, cannabis,
hallucinogens, sedatives, antianxiety drugs, amphetamines, and cocaine. << correct answer >>Substance
Withdrawal delirium Withdrawal from certain substances can precipitate symptoms of delirium that
are sufficiently severe to warrant clinical attention. These substances include alcohol; opioids; sedative,
hypnotics, and anxiolytics; and others. << correct answer >>Anticholinergics Atropine



GI - Slows motility, spasm

Eyes - Dilates pupils *DO NOT GIVE TO GLAUCOME PTS*

Heart - Increase HR

Resp - bronchodilator (Atrovent) << correct answer >>immobility and boredom are a risk factor for
delirium. << correct answer >>Systemic and central nervous system causes of delirium Systemic
Causes

Cardiovascular disease:

Congestive heart failure

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