Exam (elaborations)
NR 601 Final combined A+ Marking Scheme 2024 (1).
NR 601 Final combined A+ Marking Scheme 2024 (1).
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NR 601 Final combined A+ MarkingScheme 2024
_________ is an acute onset of memory deficit, disorientation, attention issues with
fluctuation in status based on situation and IS reversible - ANS-delirium
__________ is insidious in onset with progressive decline in cognition - ANS-dementia
What is the Mini-Cog? - ANS-a routine screening tool that test pt's executive function,
ability to plan, manage time, organize activities, manage working memory
what are the parts of the mini cog - ANS-3 word recall and draw a clock
what are the total points of the mini cog test and what does the score mean - ANS-out
of 5 ; less than 4 - screen further, les than 3 - suspicious for dementia
symptoms in delirium (11) - ANS-acute mental change
fluctuating
attention issue
memory issue
orientation issue
perceptual issues
though issue
sleep issue
consciousness issue
speech issue
psychomotor issue
potential contributing factors to delirium development - ANS-medications, alcohol,
infxn, hypoxia, surgery, sleep disturbances
what particular medication class is strongly associated with delirium in older adults -
ANS-anticholinergics
why are antihistamines like benadryl and hydroxyzine not recommended for older adults
,- ANS-anticholinergic activity - promotes delirium
labs that should be checked in patient with delirium (7) - ANS-UA
Creatinine
sodium
potassium
calcium
glucose
CBC
sedative agent considered okay to use in patient with delirium while being treated -
ANS-haloperidol (or ativan if alcohol related)
opiates to avoid in older adults due to delirium concerns - ANS-tramadol
meperidine / demerol
codeine
sleep aid safe for older adults (less concern for delirium) - ANS-trazadone
what are the biomarkers associated with neurocognitive disorder (5) - ANS-amyloid beta
42
phosphorylated / total tau
APOE4
Brain derived neurotrophic factor
ubiquitin
what tool is used to detect delirium reliably in under 5 minutes ? - ANS-CAM / confusion
assessment model
What is the Confusion Assessment Method (CAM)? - ANS--Standardized assessment
tool used to quickly identify delirium in a hospitalized patient
what is on the CAM - ANS-squeeze hand when letter A is said, disorganized thinking
questions, hold up fingers
what is mild cognitive impairment - ANS-patient or family may report decline in memory
or other cognition but function is preserved.
types of MCI - ANS-amnestic and dysexecutive
, what is amnestic MCI - ANS-primarily relating to memory
what is dysexecutive cognitive impairment - ANS-emotional, motivational, behavioral
symptoms
type of MCI that more often progresses to alzheimers / dementiaa - ANS-amnestic
what is the clinical dementia rating CDR scale / what do scores mean - ANS-rating
device that rates based on memory, orientation, judgement, problem solving, etc. score
is 0 to 3, 0 being no dementia 3 being severe impairment
what is the mini mental state exam MMSE - ANS-a screening tool used to monitor
changes in cognition
11 questions / includes orientation, registration, calculation, etc.
max score is 30 with < 23 being indicative of cognitive decline
mild dementia CDR score / MMSE score - ANS-MMSE 20 to 26
CDR 1
moderate dementia CDR score and MMSE score - ANS-CDR 2
MMSE 12 to 19
severe dementia CDR and MMSE scores - ANS-CDR 3
MMSE <12
forgetting key events, repeat questioning, misplacing objects, issues with bill pay are
associated with what level of dementia - ANS-mild
loss of communication, sleep dysregulation, loss of motor fxn, weight loss, mobility loss
are associated with what stage of dementia - ANS-severe
issues with reading and writing, communication change, irritation and irritability,
impulsivity are associated with which stage of dementia - ANS-moderate
what is anosognosia - ANS-Patient does not recognize the presence or severity of his
illness
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