Ch 13- Neurocognitive disorders

mental state characterized by an acute disturbance of cognition, which is manifested by short-term confusion, excitement, disorientation, and a clouding of consciousness
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Terms in this set (30)
-difficulty sustaining and shifting attention
-Extreme distractibility
-Disorganized thinking
-Speech that is rambling, irrelevant and incoherent
-Impaired reasoning ability and goal-directed behavior
-disorientation to time and place
-impairment of recent memory
misperception of the environment (illusions and hallucinations)
-disturbance in LOC, with interruptions in sleep-wake cycle
-Emotional instability
What occurs in Stage 2 (forgetfulness) of AD?individual begins to forget names or lose thingsWhat occurs in Stage 3 (Mild Cognitive Decline) of AD?-interference with work -may get lost while driving -difficulty recalling names/wordsWhat occurs in Stage 4 (Mild-to-Moderate Cognitive Decline) of AD?-forgets major events in personal history -decrease in ability to perform tasks -denies a problem exists -confabulationCreating imaginary events to fill in memory gapsconfabulationWhat occurs in stage 5 (moderate cognitive decline) of AD?-loses ability to perform ADL's -may forget addresses, phone numbers, and names -disoriented to place and timeWhat occurs in stage 6 (Moderate-to-Severe Cognitive Decline) of AD?-unable to recall recent major life events or even names of spouse -disorientation to surroundings -unable to recall day, season, or year -wandering, obsessiveness, agitation, and aggression -sundowning -communication is difficult -urinary and fecal incontinence common -institutional care usually requiredsymptoms of AD worsen in late afternoon and eveningsundowningWhat occurs during stage 7 (severe cognitive decline) of AD?-unable to recognize family -commonly bedfast and aphasic -immobility problems such as decubiti and contracturesWhat are the characteristics of NCD due to AD?-onset slow and insidious -course usually progressive and deteriorating -etiology includes acetylcholine alterations, plaques and tangles, head trauma, genetic factorsWhat are the characteristics of Vascular NCD?-due to significant cerebrovascular disease -more abrupt onset and runs highly variable course -etiology includes HTN, cerebral emboli and thrombusWhat are the characteristics of Frontotemporal NCD?-shrinking of frontal and temporal lobes of the brain -cause unknownWhat are the characteristics of NCD due to traumatic brain injury?-amnesia -repeated head trauma can result in emotional lability, dysarthria, ataxia, impulsivityWhat are the characteristics of NCD due to Lewy body disease?-Similar to AD, but more progressive -Appearance of Lewy bodies in cerebral cortex and brainstem -progressive and irreversibleWhat are the characteristics of NCD due to Parkinson's Disease?-loss of nerve cells and decrease in dopamine -sometimes resembles ADWhat are the characteristics of NCD due to HIV infection?-brain infections with opportunistic organisms or by HIV-1 virus -symptoms range from barely perceptible to acute delirium to profound cognitive impairmentWhat are the characteristics of NCD due to Huntington's Disease?-usually declines into profound state of dementia and ataxia -course of disease based on age of onsetWhat are the characteristics of NCD due to Prion Disease?-insidious onset and rapid progression from diagnosis to death in less than 2 years -usually occur between 40 and 60What are other medical conditions that can cause NCD?hypothyroidism, hyperparathyroidism, pituitary insufficiency, uremia, encephalitis, brain tumor, pernicious anemia, thiamine deficiency, MS, uncontrolled epilepsy, cardiopulmonary insufficiency, fluid and electrolyte imbalances, CNS and systemic infections, SLEWhat medication is prescribed for agitation and aggression in delirium?low-dose antipsychoticsWhat medication is prescribed when the etiology of delirium and substance withdrawal?benzodiazepines