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Delirium and DementiasPsychiatric Nursing: Contemporary Practice

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What interventions can a nurse use to reinforce short and long term memories for a patient with AD?
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Remind them what they ate for breakfast, who their visitors were, encourage them to tell stories of their past, Fill in the blanks matter of factly when they are word searching, use scents to stimulate memory retrieval.
What should a nurse do when a patient with AD is experiencing delusions?
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Don't attempt to ease the patient's suspicions or delusions directly. Don't correct the patient's perceptions. Determine the curcumstances that trigger suspicion/delusions and create a means for avoiding those situations.
What should a nurse do to help manage hallucinations experienced by a patient with AD?
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If they are frightening, they usually require antipsychotic medications. A nurse can cover mirrors or turn off the television if they are triggering the hallucination, encourage the patient to stay close to their caregiver, provide specific interventions for the specific hallucination (bugs on legs, suggest lotion), and let them know their feelings are justified based on their perception of the threat.
T/F If a patient with AD is experiencing depression, you should make them interact with others or participate in activities and encourage exercise.
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False, you don't make them participate in activities or interact with others, but you do encourage exercise and activities.
What are some of the best ways to help manage anxiety in patients with AD?
Show Answer
Lower the demands or perceived demands on the patient to promote comfort. Be sensitive to an AD patient's pronounced startle reflex and hypersensitivity to touch. Simplify routines, be consistent and predictable, reduce the number of choices the patient makes, create an environment where the patient feels safe.
What should a nurse do while a patient is experiencing a catastrophic reaction?
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Remain calm, minimize environmental distractions, get the patient's attention, assure them they are safe. Give info slowly, one step at a tme and let them know you understand whatever emotion (fear, anxiety, anger, etc.) they are experiencing.
The need for __________ can be an antecedent for a catastrophic event.
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stimulation
The more severe the dementia, the less ________ can be integrated, increasing the risk of a catastrophic reaction.
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stimulation
__________ refers to the brain's ability to operate effectively even when there is disruption in functioning.
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Cognitive reserve
What lifelong activities can help build and maintain cognitive reserve?
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Exercise, nutrition, stress management, social engagement, education and being literate.
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________ dementia results from a series of small stroke damage or destroy brain tissue.
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Vascular
What are the primary causes of strokes that cause vascular dementia?
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High blood cholesterol, diabetes, heart disease, and high blood pressure (the highest risk factor).
What does the brain look like in patients with vascular dementia as opposed to those with AD?
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There are multifocal lesions rather than generalized cortical atrophy that's seen with AD
How does vascular dementia typically present/progress?
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The onset tends to be more sudden, intermittent and fluctuating, with a step-like deterioration. The patient's cognitive function can improve and plateau for a period of time followed by a rapid decline after another series of small strokes.
The _________ is a diagnostic tool that is useful in differentiating vascular dementia from AD.
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Hachinski Ischemia Score
What should a nurse suspect if a patient show signs of progressive decline in intellectual functioning after a single incident of head trauma?
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The possibility of another superimposed process (usually dementia from head trauma is not progressive)
What is dementia pugi listica?
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A form of dementia that develops from repeated head injuries, also called punch-drunk syndrome?often sustained by boxers
What type of dementia is associated with Parkinsons?
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Subcortical
_________ medications are likely to increase cognitive impairment in patients with Parkinsons (caused by lack of dopamine).
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Anticholinergic
Dementia caused by Huntington's occurs in which lobe of the brain, and what symptoms occur from it?
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The frontal lobe leading to behavioral problems and disruption of attention
Dementia caused by Pick's Disease affects the _________ of the brain and isn't distinguishable from AD until autopsy.
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Frontal and temporal lobes of the brain
  
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