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Week 13 Learning Outcomes

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Week 13 Learning Outcomes

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  • May 11, 2023
  • 10
  • 2022/2023
  • Class notes
  • Kathy
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Week 13: Dementia

1. Discuss current issues, trends and research related to delirium, dementia, or
Alzheimer’s Disease.
 Cognition
o Activities of the mind involved in thinking and thought processes
o Involves different domains
o Includes intelligence, learning, judgement, reasoning, knowledge,
understanding and memory (higher levels)
o Attention and orientation (lower level domain).
o Interrelates with the key aspects of the individual (physical, psychological,
social, and spiritual).
 Confusion
o Cognitive impairment is a disruption in higher brain functions that results
in confusion (Morrison Valfre, 2021, p.192)
o Means a disorder, bewilderment or uncertainty.
o Confusion is not normal.
o Is an indication of an underlying problem that requires immediate
attention.
o Can be acute, subacute, chronic, reversible or irreversible.
o Sources of confusion: The 6 D’s = damage, delirium, deprivation,
dementia, depression, and drugs.
 Delirium
o It is acute confusion, and a change of consciousness
that occurs quickly
o Is a medical emergency that requires immediate
attention to prevent serious damage.
o Reversible, if treated early.
o Can result in further complications and prolonged
hospital stay.
o Occurs primarily in the elderly population but can
also occur in younger adults.
o A disturbance in Attention and Level of Consciousness

o A disturbance in Awareness-reduced orientation to the environment .
o There is an acute (hours-weeks) change in the persons baseline attention,
o awareness, memory and/or language .
o Fluctuates during the day
o Risk Factors: Delirium
 Older than 65 yrs. old
 Pre-existing dementia
 Male
 Poor vision/hearing

,  Mild cognitive impairment
 Depression
 Polypharmacy
 Poor ADL function
 Multiple comorbidities
o Causes
 Rapid onset hours to days, evidence of physical condition,
cognitive changes decrease/increase attention to environmental
stimuli
 It is multifactorial. It can result from an infection such as UTI,
Pneumonia, or Sepsis
 Subdural hematoma intoxication CVA, CHF, Medications (Ativan),
poly-pharmacy, dehydration, electrolyte imbalance, MI,
hypoglycemia, hypoxia TIA, Stroke
o Precipitating Factors of Delirium




o Signs and Symptoms of Delirium
 Cardinal signs based on the Confusion Assessment Method (CAM)
 Inattention and changes in awareness (of their environment)
 Acute onset and fluctuation (lucid during the day, delirious at
evening = sundowning)
 Disorganized thinking
 Disturbance of cognition/consciousness
o Types of Delirium and Symptoms
 Includes three sub-types:
 Hyperactive delirium: hypervigilance (very alert, constantly
scanning the room), restlessness, and psychomotor agitation
(climbing out of bed, hitting etc.)
 Hypoactive delirium: more common in older adults, include
drowsiness, lethargy, and decreased motor activity. Client may be
quieter apathetic and withdrawn.
 Combined/Mixed delirium: involves symptoms of both hyper and
hypo.
 Other symptoms = hallucinations, disturbed sleep-wake
cycle, and illusions
o Diagnosis of Delirium

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