1. Chapter 93 Dementias and Related Disorders

2. Impairment of Mental Functioning
Confusion
Delirium
Mild cognitive impairment (MCI)
Amnestic MCI
Nonamnestic MCI
Dementia
Progressive dementia
Pseudodementia

3. Question Is the following statement true or false?
A nurse needs to learn about the history of onset of cognitive dysfunction to decide if the client has confusion, delirium, or dementia.

4. Answer
True
When first meeting an individual who has a cognitive dysfunction, the nurse may find it difficult to determine if the disruption is owing to confusion, delirium, or dementia. Learning about the history of onset and observing the client’s level of consciousness and cognitive abilities can help differentiate the condition.

5. Types of Dementia Alzheimer’s disease Multi-infarct dementia
Parkinson’s disease
Wernicke-Korsakoff syndrome
Frontotemporal temporal dementia (FTD), Pick’s disease
Creutzfeldt-Jakob disease (infectious)
Huntington’s disease (HD, hereditary)
Dementia caused by AIDS

6. Types of Dementia (cont’d)
Crack-related dementia; dementias caused by other illegal drugs
Normal-pressure hydrocephalus
Brain trauma
Metabolic disorders (e.g., diabetes mellitus or end-stage renal disease)
Drug overdose (toxic dementia)
Dementia of tertiary syphilis (Bayle’s disease)

7. Dementia’s Common Terminology
Agnosia
Akinesia
Aphagia
Aphasia
Apraxia
Compulsions
Confabulation
Delusional
Dysphagia
Emotional liability
Paranoid

8. Alzheimer’s Disease Theories of causes Risk factors
Age, genetics, diet, environment
Education and continual use of mental abilities
Diseases that affect cerebral blood flow, such as stroke, heart disease, and hypertension
Low levels of the vitamin folate

9. Alzheimer’s Disease (cont’d)
Physiologic changes
Major changes occur in the brain
Cerebral cortex atrophy
Loss of neurons
Changes in brain cells

10. Alzheimer’s Disease (cont’d)
Description
Common symptoms
Memory loss, inability to learn and retain new information
Loss of judgment and planning skills
Personality and mood changes
Decreased reasoning and abstract thinking skills
Loss of language skills
Inability to care for self

11. Alzheimer’s Disease (cont’d)
Pharmacologic treatment
The goals
To prevent the development of AD
To slow the onset of symptoms
To reduce the symptoms

12. Diagnosis of Dementia History Physical and neurologic examination
Laboratory tests
CT scan, MRI, PET scan, and EEG
Psychometric testing
Functional assessment

13. Question Is the following statement true or false?
If a person with dementia who resides in a long-term care facility wants to go home, it is important for the nurse to convince this person that the facility is his or her home.

14. Answer
False
The person with dementia who resides in a long-term care facility may want to go home. The nurse should not try to convince the resident that this is his or her home. It is not the “home” the resident knows.
The nurse can make statements, such as “You are staying here. You are safe here.” Distracting the person by initiating an activity may also help.

15. Nursing Process Data collection Physical assessment
Psychological assessment
Determination of abilities to perform functional ADLs
Determination of abilities to perform complex or instrumental ADLs
Determination of support systems

16. Nursing Process (cont’d)
Planning and implementing
Assisting with daily care
Assisting with communication
Assisting with behavior management
Assisting caregivers
Evaluation

17. Question Is the following statement true or false?
When communicating with a person with dementia, a nurse should restrain the person.

18. Answer
False
Restraints should be used only as a last resort. Restraining a client with dementia often causes more aggression. If the client becomes combative or hostile, have a safe place or room the client can stay and be monitored but not physically restrained.

19. End of Presentation