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DISORDERS
SITE MAP
OVERVIEW
DELIRIUM
DEMENTIA
PARKINSONS
DISEASE
AMNESTIC DISORDERS
COMMUNITY BASED CARE
OVERVIEW
DELIRIUM
DELIRIUM
Etiology
Etiology (contd)
Symptoms
Symptoms (contd)
Hypoglycemic
agents
Insulin
Cardiac glycosides
Narcotics
Propranolol
Reserpine
Thiazide diuretics
Medical Management
Hypoactive
delirium - No specific
pharmacologic treatment
Sedatives to prevent inadvertent selfinjury but sedatives and benzodiazepines
are avoided this may worsen delirium
Exemption to this is delirium induced by
alcohol withdrawal.
Haloperidol
0.5-1 mg to decrease
agitation
Supportive medical measures
Assessment
History
Nursing Diagnosis
Risk
for injury
Acute confusion
Disturbed sensory perception
Disturbed thought processes
Disturbed sleep pattern
Risk for deficient fluid volume
Risk for imbalanced nutrition: less than
body requirement
Objectives
The
Nursing Interventions
Ensure
clients safety
Managing
clients confusion
Nursing Interventions
(contd)
Controlling
overload
Promoting
Evaluation
The
DEMENTIA
Dementia
Dementia
Classifications of Dementia
Dementia
is classified as cortical or
subcortical depending on the area of brain
affected.
Cortical Dementia
Subcortical Dementia
Subcortical
Types of Dementia
Alzheimers
Disease
is
Vascular
Dementia
Disease
Pick's
Creutzfeldt-Jacob
is
Disease
Huntingtons
Disease
Huntington's
HIV
Dementia
AIDS
Parkinsons Disease
Dementia caused by head trauma
4 As in dementia
Amnesia
memory impairment
Aphasia
language disturbance
Apraxia
Alzheimer's disease
Limbic encephalitis
Vascular dementia
Heavy metal exposure
Lewy body disease
Normal pressure
hydrocephalus
Parkinson's disease
Post-traumatic
dementia
Pick's disease
Multiple sclerosis
Jakob-Creutzfeldt
disease
Idiopathic basal ganglia
calcification
Neurosyphilis
Acquired immune
deficiency syndrome
(AIDS)
Fungal infections
Tuberculosis
Progressive
supranuclear palsy
Huntington's disease
Diagnostic Exam
Psychological Tests
Neurological Tests
Electroencephalograph (EEG) measures
electrical activity of brain cells
Computerized Axial Tomography (CAT)
assessed brain damage by X-ray
Positron Emission Tomography (PET)
glucose metabolism in brain is monitored
Cerebral Blood Flow patient inhales
radioactive gas and blood flow is monitored
Magnetic Resonance Imaging (MRI) patient
placed in magnetic field and radio waves used
to produce picture of brain.
Mental Status Exam
Physical Status Exam
Laboratory tests targeted at identifying
general medical and substance-related causes
Assessment
Nursing Diagnosis
Objectives
The
Nursing Interventions
Promote
clients safety
Promote
Structure
Nursing Interventions
(contd)
Provide emotional support
Be kind, respectful, calm, and reassuring, pay
attention to client
Use supportive touch when necessary
Promote interaction and involvement (Milieu
management)
Plan activities according to clients interest and
abilities
Allow the client to have familiar objects around
him/her -> reality orientation, self-worth, dignity
Reminisce with client about the past
Be alert to nonverbal cues
Employ techniques of distraction
Provide a list of community resources, support groups,
care basic
Preventing injury for the client accidental injury
Others
Dealing with pts specific behaviors ie
agitation,
Do not challenge pts memory
Evaluation
The
Delirium
Dementia
Development
Sudden
Slow
Duration
Days to weeks
Months to years
Possibly none
Variation at night
Often worse
Attention
Greatly impaired
Level of consciousness
Orientation to surroundings
Varies
Impaired
Use of language
Memory
Mental function
Cause
Nonemergency medical
attention
PARKINSONS DISEASE
Parkinsons Disease
OBJECTIVES
Identify and assess nonmotor
symptoms in patients with
Parkinson's disease.
Discuss the impact of these
symptoms on patients with PD.
Offer treatment strategies to improve
nonmotor symptoms.
NONMOTOR SYMPTOMS OF
PARKINSONS DISEASE
Neuropsychiatric
and cognitive:
Depression
Anxiety
Psychosis
Dementia
Apathy
Fatigue
Sleep disturbance
Executive
impairment common to PD
age
Lower level of education
Increasing severity and longer
duration of PD
atypical Parkinsonism
Psychiatric correlates or risk factors
include psychosis, apathy and
depression
AMNESTIC DISORDER
Amnestic Disorder
COMMUNITY-BASED
CARE
Community-Based Care
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