-
What are the two main precipitating factors that cause delirium?
-
What is the difference between delirium and dementia?
Delirium - clear onset, acute
Dementia - progressive onset, not noticeable of when it occurs
-
Ways to treat delirium
- Detect it early
- Review medication
- Evaluate for infection
-
How will the nurse care for a patient with delirium?
- Treat underlying cause
- Calm environment
- Avoid restraints
- Limit sedatives
-
Dementia
Normal part of aging?
Most common etiology?
NO!
Alzheimer's Disease
-
D.E.M.E.N.T.I.A
Make sure the patient doesn't have any problems with:
- Drug and Alcohol
- Eyes and Ears
- Metabolic/Endocrine Disorders
- Emotional Disorders
- Neurologic Disorders
- Tumors or Trauma
- Infection
- Arteriovascular Disease
-
Vascular Dementia:
Risk factors?
Treatment?
HTN, smoking, diabetes
- SSRI and Psychotherapy
- (same treatment as geriatric depression)
-
What type of dementia is this?
Loss of short-term memory
Decreased learning
Loss of judgment
"I know but you don't"
Early Dementia
(Pt. knows something is wrong but is not noticed by others)
-
What type of dementia is this?
Profound memory loss
Confused
Word finding difficulty
Wandering
"We both know it"
Middle Dementia
-
What type of dementia is this?
Dependent on ADL
Non-verbal
Immobile
Weight loss
"You know but I don't"
Late Dementia
-
What two main drugs treat dementia?
- Cholinesterase inhibitors
- Memantine (Namenda)
(Not cures, just delays the disease)
-
Cholinesterase inhibitors:
For what types of dementia?
What drugs?
S/S?
Mild to moderate
- Donepezil (Aricept)
- Rivastigmine (Exelon)
- Galantamine (Razadyne)
- GI upset
- Bradycardia
- Syncope
-
Memantine (Namenda):
For what types of dementia?
MOA?
S/S?
Mild, Moderate, Severe
Suppresses glutamate
Sedation
-
What kind of drugs should be used as a last resort and in the lowest possible dose for agitated and aggressive dementia patients?
Atypical Antipsychotics:
- Risperidone (Risperdal)
- Olanzapine (Zyprexa)
-
Rosemary an 80y/o female presents to the ER for a change in mental status. What is your priority nursing action?
C) Check vital signs, pulse ox and accu-check
-
Which of the following is NOT true of depression in the elderly?
C) They are not high risk for suicide
|
|
