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NU 386 Exam 2 Guide With Complete Solution
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NU 386 Exam 2 Guide WithComplete Solution
Laboratory tests: Normal Ranges
CBC:
Hemoglobin (Hgb)- Male: 13.5-18%, Female: 12-16%
Hematocrit (Hct)- Male: 40-45%, Female: 38-47%
Platelets (PLT)- 150,000-450,000
Coagulation:
Prothrombin time (Pt)- 11-13.5 sec
INR- 2.0 to 3.0 on warfarin
PLT- Warfarin should be held if PLT count is low
d-dimer- <0.50
Respiratory:
Oxygen Saturation- 95-100%
HCO3- 22-28 mEq/L
ABG- pH (7.35-7.45) PaO2 (75-100 mmHg) PaCO2 (35-45 mmHg)
What is Alzheimer's disease?
-Dementia that is characterized behaviorally by anterograde amnesia (can
,remember the past but cannot form new memories).
-Visual memory is also impaired, leading to confusion with regard to
orientation
Pathophysiology/Etiology: Alzheimer's Disease
Changes in brain structure and function
-Amyloid plaques: abnormal clusters of beta amyloid fragments that build up
between nerve cells
-Neurofibrillary tangles: destroy the transport system for nutrients that is
made up of proteins
-Loss of connections between neurons
-Neuron death
S/S of Alzheimer's Disease
-Memory loss that affects job skills
-Problems with abstract thinking
-Difficulty doing familiar tasks
-Poor or decreased judgement
-Problems with language
-Misplacing things
-Changes in mood
-Changes in personality
-Loss of initiative
,Assessment for Alzheimer's
loss in mini-mental scale, clock drawing, 3-word recall test
Diagnosis of Alzheimer's
-Thorough history & physical
-Rule out other possibilities
-Labs: vitamin B12 or B1 deficiency, electrolyte imbalance, thyroid disorders,
infections (UTI)
-Biomarkers: research only
-MRI, CT, PET
-Lumbar puncture: sBPP in CSF (soluble beta protein precursor)
-MMSE or Mini-cog
Nursing Interventions: Alzheimer's Disease
-No cure
-Minimizing undesirable behaviors/providing support for family
-Assess cognitive status
-Bowel/Bladder program
-Safe environment
-Frequent walks
-Verbal/nonverbal communication
-Assess skin regularly
, -Cognitive stimulation
-Memory training exercises
-Avoid overstimulation
-Promotion of self-care
-Provide routines
Medication Interventions: Alzheimer's & Dementia
Acetylcholinesterase Inhibitors (AChEIs)- Donepezil (Aricept), Galantamine
HBr (Razadyne): Slows breakdown of ACh
Glutamine Pathway Modifiers- Memantine (Nemenda): Regulates abnormal
glutamine
Antipsychotics-haloperidol (Haldol): FDA has warned that antipsychotics are
not indicated for treatment of dementia related psychosis. There is an
increased risk of CVA and death in older adult with dementia
Antidepressants- citalopram (Celexa), fluoxetine (Prozac): may improve
cognitive ability and problems related to sleep
Anxiolytics- lorazepam (Ativan), oxazepam (Serax)
-AD meds may slow the course of the disease, but do not work for everyone
What is Dementia?
A chronic or persistent disorder of the mental processes caused by brain
disease or injury and marked by memory disorders, personality changes, and
impaired reasoning
What are the causes of Dementia?
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