NSG 123 Medical Surgical Nursing: Exam 4 (Modules 8, 9, 10, 11) Already Graded A

NSG 123 Medical Surgical Nursing: Exam 4 (Modules 8, 9, 10, 11) Already Graded A Delirium Definition State of temporary acute mental confusion. Usually develops over a 2-3 day person. It is life-threatening & possibly preventable syndrome. Most frequent complication of hospitalization in older adults. Priority of safety and treating underlying cause. Delirium, often called acute confusional state, begins with disorientation and, if not recognized and treated, can progress to changes in level of consciousness, irreversible brain damage, and sometimes death Dementia Definition Initial symptoms are related to changes in cognitive function. The cognitive, functional, and behavioral changes that characterize dementia eventually destroy a person's ability to function. The symptoms are usually subtle in onset and often progress slowly until they are obvious and devastating. Family members often report to doctor: Memory loss, Mild disorientation, Trouble with words and/or numbers Confusion: Suspected Elderly Abuse Neglect or abuse of the patient can occur, and this has been documented in home situations as well as in institutions. If neglect or abuse of any kind—including physical, emotional, sexual, neglect, or financial abuse—is suspected, the local adult protective services agency must be notified. The responsibility of the nurse is to report the suspected abuse, not to prove it. What is the point of medications in Alzheimer's? Slow the Progression What two categories of medications are used to treat Alzheimer's? Acetylcholinesterase inhibitor & N-methyl-D-aspartate receptor antagonist N-methyl-D-aspartate receptor antagonist: Name? What Disease? What to watch for? What does it do? Alzheimer's Memantine- Namenda Decreases glutamate circulation in the brain • Watch renal disease Acetylcholinesterase Inhibitor: Name? What Disease? What to watch for? What does it do? Alzheimer's Increases uptake of acetylcholine (Donepezil- Aricept, Rivastigmine- Exelon) • Watch liver disease Cardinal Signs of Parkinson's Symptoms: Tremor, Rigidity, Bradykinesoa (overall slowing of active movement), Postural Instability (postural and gait problems), Gradual onset, symptoms progress slowly over a chronic, prolonged course Diagnosis of Parkinsons: Although laboratory tests and imaging studies are not helpful to the clinician in diagnosing PD ongoing research with PET and single-photon emission computed tomography scanning has been helpful in understanding the disease and advancing treatment. Currently, the disease is diagnosed clinically from the patient's history and the presence of two of the four cardinal manifestations: tremor, rigidity, bradykinesia, and postural changes. CT scan can show some chronic changes but will not change long term outcomes. The medical history, presenting symptoms, neurologic examination, and response to pharmacologic management are carefully evaluated when making the diagnosis. Confirmation Diagnosis of Parkinson's Give patient Levodopa-Carbodopa and see if they respond to it or not. What does Levodopa do? & What disease is it used in? Increases dopamine available in the brain Parkinson's What does adding Carbidopa to Levodopa do? What disease is it used in? Adding Carbidopa can slow how quickly Levodopa is absorbed Parkinson's What is the brand name of Carbidopa/Levodopa? Simemet Why would a provider add Entacapone (Comtan) to a Sinemet medication regimen? Works well in combo with Simemet What does Amatnadine (Symmetrel) do? increases dopamine release in the nigrostriatal pathway 2