Exam 2 NUR 2459 Study Guide

Exam 2 NUR 2459 Study Guide – Winter 2021 Exam 2 Study Guide We will continue to build on ALL of the first exam insights further advancing our knowledge, skills and attitudes with communication, ethics, Legal, therapies, barriers, boundaries, safety considerations, Patients’ rights, HIPPA, defense mechanisms, communication techniques (therapeutic communication), dosage and calculation, and etc… New Material will include topics from week 4 through week 6 Care of the client with Neurocognitive disorders (Alzheimer’s, Delirium, Types of NCD, NMS) Delirium: is characterized by a disturbance in attention and awareness and change in cognition that develops rapidly over a short period. Differentiating delirium from dementia can be a difficult process, but failure to recognize delirium and the cause can delay appropriate treatments causing serious consequences. Examples of causes: Systematic infections, Febrile illness, Head trauma, Seizures, Migraine headaches, Stroke, Electrolyte imbalance, Post-operative state. Symptoms: Disorganized thinking (rambling speech, irrelevant, pressured, incoherent) Shifting attention, Very distractible, Lack of focused attention, Disorientation, Impairment of recent memory, Misperceptions of the environment, Illusions, hallucinations o State of awareness my range from hypervigilance to stupor. o Sleep may fluctuate between hypersomnolence and insomnia. o Psychomotor activity may fluctuate between agitated, purposeless movements to a state resembling catatonic stupor. Emotional instability may be manifested by anxiety, fear, irritability, anger, euphoria or apathy. These emotions may be evidenced by crying, calling for help, muttering and moaning. Autonomic symptoms: Tachycardia, Sweating, Flushed face, Dilated pupils, Elevated blood pressure 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