...Disorders namely Vascular Dementia and Alzheimer’s Dementia, the various domains that can be affected as well as the cross- cultural factors to take into consideration 1 2 Contents Introduction: Neurocognitive Disorders (NCD)/ Dementia 4-5 Mild and Major NCD criteria 5-6 Diagnosing a patient with Vascular Dementia 7-8 Diagnostic criteria for Alzheimer’s Dementia 8-9 Delirium (acute confusional state/ acute brain syndrome) Cross- cultural and contextual perspectives of health 9-11 11-14 - India - Egypt - Islam References 15-16 3 Introduction: Neurocognitive Disorders/ Dementia Neurocognitive disorders (NCD) are a group of disorders in the DSM-5 classification system. These disorders involve the impairment of an individual’s cognitive abilities that involve tasks such as, memory, judgement, problem solving and perception (Burke. A, 2014). Only disorders that show evidence of cognitive deficiencies are classified as NCDs. To name a few, these cognitive deficiencies can be a result of; Traumatic Brain Injury (TBI), HIV/AIDS or substance abuse (Burke. A, 2014). The DSM-5 classifies Neurocognitive disorders into three categories, namely, Delirium and Major or Mild NCD. “Within each group, there are further subgroups which are organised according to their aetiology” (Burke. A, 2014: 244) and pathology. As the DSM-5 refer to such disorders as NCD, the ICD-10, still uses the term, Dementia to refer to disorders...
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...Assessing Mental Status Most of a mental status assessment can be done during an interview. Assess the patient’s appearance, behavior, mood, thought processes and cognitive function, coping mechanisms, and potential for self-destructive behavior. Record your findings. Most of us already do an assessment of mental status everyday, esp. in our jobs. But now we are going to take a little closer observation. Mental Status exam is a FOCUSed exam. Used for screening, assess state of consciousness (expected or unexpected) or to assess whether the patient is experience delirium versus dementia. Past Medical and Family History Any history of * Neurological disorders * Brain surgery * Psychiatric counseling * Mental retardation * Alzheimer disease * Learning disorders Personal and Social History Pertinent data should include: · Emotional status · Life goals, relationship with family members · Intellectual level · Sleeping/eating patterns, weight loss/gain · Anxiety · Use of alcohol or street drugs Age and Condition-Related Variations * Children * Areas relevant to children are speech & language, behavior, performance of self-care activities, personality and behavior patterns and learning difficulties * Older Adults * Ask about any experiences with depression, or changes in mental functions Let’s look at appearance… this can help to indicate emotional and mental status, specifically noting his/her dress and grooming. Some things...
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...CLINICAL ISSUES Acute care management of older people with dementia: a qualitative perspective Wendy Moyle, Sally Borbasi, Marianne Wallis, Rachel Olorenshaw and Natalie Gracia Aim and objectives. This Australian study explored management for older people with dementia in an acute hospital setting. Background. As the population ages, increasing numbers of older people with dementia are placed into an acute care hospital to manage a condition other than dementia. These people require special care that takes into account the unique needs of confused older people. Current nursing and medical literature provides some direction in relation to best practice management; however, few studies have examined this management from the perspective of hospital staff. Design. A descriptive qualitative approach was used. Method. Data were collected using semi-structured audio-taped interviews with a cross section of thirteen staff that worked in acute medical or surgical wards in a large South East Queensland, Australia Hospital. Results. Analysis of data revealed five subthemes with the overarching theme being paradoxical care, in that an inconsistent approach to care emphasised safety at the expense of well-being and dignity. A risk management approach was used rather than one that incorporated injury prevention as one facet of an overall strategy. Conclusion. Using untrained staff to sit and observe people with dementia as a risk management strategy does not encourage an evidence-based approach...
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...An Overview of Dementia: How It Has Touched My Life Dementia is an illness that occurs when there is a loss of brain function as a result of the presence of certain diseases. Dementia affects a person’s memory, judgment, behavior, thinking, and language. Dementia includes Alzheimer’s disease (AD) and tends to increase the most from the age of 65. Various references and literature in reference to dementia indicate that the number of patients with dementia will increase significantly as society ages, especially within the next three decades. Dementia causes significant family issues and can become a financial burden on patients and their family members. These burdens impair the ability of a person to function independently and also have a tremendous impact on his or her relationships and quality of life. The subject of this paper will discuss an overview of dementia, treatments of dementia, how it affects human lives, and also the affect dementia has had on the life of the writer of this paper An Overview of Dementia: How It Has Touched My Life As a child growing up in the early 1970s, the writer of this paper can recall his neighborhood. It was peaceful and had a several people who were known elderly and considered as senior citizens. The writer of this paper also remembers when the adults of the neighborhood would speak of the elderly and tend to talk the most about their strange behaviors. Although this was often the case, the talk of...
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...exactly of where or who you are, what time it is or who is talking to you. This exact scenario is a daily way of life for those suffering from cognitive impairments. According to the Centers for Disease Control, cognitive impairment is when a person has trouble remembering, learning new things, concentrating, or making decisions that affect their everyday life (Centers for Disease Control [CDC], 2011). Non-white Hispanics suffer from cognitive impairment at an alarming rate. The rise in cognitive impairments is the result of several factors including the prevalence of certain medical conditions and socioeconomic status. The term cognitive impairment is classified under several axis I mental alterations. These alterations include delirium, dementia and amnestic disorders (Diagnostic and Statistical Manual of Mental Disorders [DSM-IV-TR], 2000). Many internal and external factors can lead to the development or exacerbation of these mental alterations. Internal factors, such as hypertension, diabetes, neurodegenerative disorders, nutritional, metabolic and endocrine disorders and infectious disorders are all examples of medical conditions that can contribute to cognitive impairment (Round, 2010). External factors include educational background and socioeconomic factors. Already the largest minority, Hispanics are also the fastest growing ethnic population in the United States (The Americano, 2011). The rise in the population of Hispanics also makes the prevalence of certain...
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...BIO483 Exam #4 Review Comprehensive and/or early Weeks Know all conditions that cause splenomegaly All associated diseases with EBV Week 1 Mechanisms of Cellular Adaptation Types of necrosis and pathology where most likely found. Apply the definitions of Atrophy, hypertrophy, hyperplasia, hypoplasia, dysplasia, and metaplasia. Week 2 Pain Throughout Organ Systems General anatomy of kidneys, appendix, gallbladder, pancreas, spleen, male and female reproductive organs. Costochondritis vs Angina Pectoris vs Myocardial Infarctions. Rheumatoid arthritis Gout lab findings Week 3 Fluid Balance and Edema Electrolyte imbalances of sodium, potassium, calcium, and magnesium. Intra and Extra cellular concentrations of sodium and potassium as related to osmotic balance. Know the physical signs/symptoms of electrolyte imbalances including hyper and hypo natremia, kalemia, and calcemia. SIADH lab and imaging findings Diabetes insipidus lab and imaging findings Week 4 Topic 4 Acidosis and Alkalosis Know your acid-bases! Week 5 Topic 5 Cardiovascular Causes of Fatigue Cor-pulmonale, cardiomyopathies Week 6 Topic 6 Thyroid, Adrenal, Liver Fatigue Hashimoto’s thyroiditis vs. DeQuervain vs. nodular goiter vs. secondary hypothyroidism Cirrhosis, Addison disease lab tests and hormone responsible. Is it high or low? Week 7 Topic 7 Bleeding as Indicator of Disease Pathophysiology of Disseminated Intravascular Coagulation Pathophysiology of Hemophilia Ulcers ...
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...you feel sense of depression. This means, as a person grows old he/she experiences deterioration in one’s self. Now, we are currently living in the age of technology. Our advancements in the past few decades overshadow everything learned in the last 2000 years. This increase has bought with it a large increase in disease afflicting the elderly community. AD once thought to be a natural part of aging, is a severely debilitating form of mental dementia. Although some other types of dementia are curable or effectively treatable, there is currently no cure for Alzheimer. A general overview of AD including the clinical description, diagnosis, and progression of symptoms, helps one to further understand the treatment and care of patients. Alzheimer’s is a type of dementia that causes problems with memory, thinking, and behavior. Alzheimer’s is the most common form of dementia, a general term for memory loss and other intellectual abilities serious enough to interfere with daily life. Alzheimer’s disease accounts for 50 to 80 percent of dementia cases. The primary risk factors of Alzheimer’s are age, family history, and genetics. However, there are other risk factors that you can influence. Alzheimer’s is not a normal part of aging, although the greatest know risk factor is increasing age,...
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...Alzheimer's disease is the most common cause of dementia. The word dementia describes a set of symptoms that can include memory loss and difficulties with thinking, problem-solving or language. These symptoms occur when the brain is damaged by certain diseases, including Alzheimer's disease. This factsheet describes the symptoms of Alzheimer's disease, how it is diagnosed, and the factors that can put someone at risk of developing it. It also describes the treatments and support that are currently available. Alzheimer's disease, named after the doctor who first described it (Alois Alzheimer), is a physical disease that affects the brain. There are more than 520,000 people in the UK with Alzheimer's disease. During the course of the disease,...
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...integrates principles of compassion and respect for patients and their families into the planning and delivery of care to a diverse population of older adults and into advocacy for vulnerable older adults. This topic addresses the following learning objectives: * Recognize the impact of attitudes, values, and expectations about aging. * Describe how the RN’s personal beliefs and values may impact the care of older adults. * Articulate the concept of individualized care as the standard of practice with older adults, considering the right care, at the right time, in the right place and by the right provider of care. * Define Baby Boomers (those born from 1946–1964) reach retirement age (as of 2011) A large group of people born between 1946 and 1964, in the time after the Second World War. * What are the five racial groups listed in your text? African American, American Indian/Alaskan Native, Native Hawaiian/Pacific Islander/Asian, Hispanic, White * How would you perform discharge teaching to an Hispanic patient Teach the family as well because more than likely, pt is going home and family is his/her primary caregivers. * Apply effective and respectful communication strategies in the care of older adults and their families. * List some of the changes of aging that could affect therapeutic communication * TABLE 4-1 Normal and Pathological Changes and Their Impact on Communication pg80 * Note the ways to communicate or assist a patient...
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...STUDY GUIDE for C475 Care of Older Adult Objective Assessment Exam questions are taken from the Learning Objectives under the 9 Competencies: #1 Competency 742.1.1: Compassionate and Respectful Care of Older Adults The graduate integrates principles of compassion and respect for patients and their families into the planning and delivery of care to a diverse population of older adults and into advocacy for vulnerable older adults. This topic addresses the following learning objectives: * Recognize the impact of attitudes, values, and expectations about aging. * Describe how the RN’s personal beliefs and values may impact the care of older adults. * Articulate the concept of individualized care as the standard of practice with older adults, considering the right care, at the right time, in the right place and by the right provider of care. * Define Baby Boomers * What are the five racial groups listed in your text? * How would you perform discharge teaching to an Hispanic patient * Apply effective and respectful communication strategies in the care of older adults and their families. * List some of the changes of aging that could affect therapeutic communication * Note the ways to communicate or assist a patient with disabilities such as hearing deficits, vision impairments, or aphasia and dysarthria. Be familiar with the types of hearing devices. How should you address the older adult during therapeutic communication? ...
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...Nursing 122 Fundamentals of Neuro-Sensory nursing --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- Review major structures and functions of both central and peripheral nervous system. (Carolyn Jarvis, Physical Examination and Health Assessment, 3rd ed., pages 688-692 Structure and function of the CNS and PNS --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- Potter and Perry, Fundamentals of nursing (8th), Chapter 16 p. 210-211 Types of Data --There are two primary sources of data: subjective and objective. Subjective data are your patients’ verbal descriptions of their health problems. Only patients provide subjective data. For example, Mr. Jacobs's report of incision pain and his expression of concern about whether the pain means that he will not be able to go home as soon as he hoped are subjective findings. Subjective data usually include feelings, perceptions, and self-report of symptoms. Only patients provide subjective data relevant to their health condition. The data sometimes reflect physiological changes, which you further explore through objective data collection. --Objective data are observations or measurements...
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...INTRODUCTION Addiction is specifically concern with the process by which drug-taking behavior, in certain individuals, evolves into compulsive patterns of drug-seeking and drug-taking behavior that take place at the expense of most other activities and the inability to cease drug-taking. THERE ARE FIVE THEORIES OF ADDICTION NAMELY; * MEDICAL MODEL * PSYCHODYNAMIC MODEL * SOCIAL MODEL * MORAL MODEL * BIO-PSYCHO-SOCIAL MODEL MEDICAL MODEL This involves * Addiction as a “brain disease” * Neurotransmitter imbalance * Disease model: * Agent: drug * Vector: dealers * Host: addict PSYCHODYNAMIC MODEL This involves the following * Drug abusers who are self-medicating * Drug abuse which is a symptom of underlying psychological problems * Drug use is also a maladaptive psychological coping strategy * Drug abusers also need to resolve internal conflict, and when they do, drug use will be unnecessary. SOCIAL MODEL This involves * Drug use as a learned behavior * People using drugs because drug use is modeled by others * Peer pressure * Environmental effects leading to drug use MORAL MODEL * Addicts are usually weak and can overcome a compulsion to use with willpower * Drug abusers are anti-social and should be punished for that * Drug are generally evil BIO-PSYCHO-SOCIAL MODEL * All the above are true, to greater or lesser degrees * Each person’s drug use is a result of some aspects of some or all...
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...the content of this article. ADDRESS FOR CORRESPONDENCE: Dr. David R. Spiegel, Eastern Virginia Medical School, Department of Psychiatry and Behavioral Sciences, 825 Fairfax Avenue, Norfolk, Virginia 23507; Phone: (757) 446-5888; Email: spiegedr@evms.edu KEY WORDS: Amnestic disorder, frontal lobe, diencephalic A Case of Probable Korsakoff’s Syndrome: A Syndrome of Frontal Lobe and Diencephalic Structural Pathogenesis and a Comparison with Medial Temporal Lobe Dementias by DAVID R. SPIEGEL, MD, and KHENG-JIM LIM, MD Drs. Spiegel and Lim are from the Department of Psychiatry and Behavioral Sciences, Eastern Virginia Medical School, Norfolk, Virginia. Innov Clin Neurosci. 2011;8(6):15–19 ABSTRACT Korsakoff’s Syndrome is an amnestic disorder that involves both anterograde and retrograde amnesia. Traditionally associated with longstanding alcohol misuse, thiamine deficiency has been long posited in its pathogenesis, as has dienecephalic lesions. Yet, through this case report, we highlight similarities (and differences) with medial temporal lobe memory disorders and the role of frontal lobe dysfunction in its retrograde amnesia. INTRODUCTION Wernicke’s encephalopathy (WE) and Korsakoff syndrome (KS) are generally viewed as two distinct stages of the same illness called Wernicke-Korsakoff syndrome (WK syndrome). WE, the acute form of the disease, consists of a degenerative brain disorder due to a thiamine deficiency (Vitamin B1), which is the same pathological state that...
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...hypertension, and urinary incontinence (UI). She is receiving carbidopa/levodopa, pramipexole, selegiline, tolterodine, diazepam, metoprolol, and hydrochlorothiazide. When she comes to your pharmacy to get her prescriptions, she walks slowly with a cane, and she is stooped over. 1. Identify age-related pharmacokinetic and pharmacodynamic changes in older people. 2. Evaluate the pharmacotherapy regimens of older people to support the maintenance of optimal physical and mental function. 3. Identify inappropriate medication prescribing in older people. 4. Recommend appropriate pharmacotherapy for patients with dementia. 5. Evaluate the risks and benefits of the use of antipsychotics (APs) (including atypical APs) in older patients with dementia. 6. Recommend appropriate interventions for patients suffering from behavioral symptoms related to dementia. 7. Identify the types of urinary incontinence and recommend appropriate treatments. 8. Given a patient’s American Urology Association Symptom Index for benign prostatic hyperplasia, recommend appropriate therapy. 9. Recommend appropriate analgesic therapy for older patients with osteoarthritis. 10. Discuss risks and benefits of medication classes used to treat rheumatoid arthritis. 2. Which of the following is the single most important intervention you can make to reduce her risk of falls? A. Suggest to J.T. that her neurologist reassess her Parkinson disease...
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...Every individual goes through different experiences while their getting older. When people age they tend to have problems these can be caused by the difference their body goes through, also this tends to happen to people who are more into their fifties. Even people who have passed the stage of 50’s can still have issues caused by the changes, which they still need to get used to because there’s no way it will change. Physical changes- while a person is aging their bodies go through many changes; these will be their skin, joint and the bones. The side effects of aging will usually be more off a wrinkled skin and also a thinner skin. People with older ages are more likely to be sensitive, their bones are more likely to break their skin is more likely to get damaged. Due to their old age they are likely to have pains within their joints. During this physical change their joins tend to become looser. They will lose weight which is caused by their cartilage become apart, also their posture starts changing they may not be able to keep a straight back due to their spine becoming round and also another change will be that their muscles will start to lose power and they will become weak. By time individuals can also experience having problems with their eye sight this could be them going through a struggle while reading or writing, some people also tend to lose their sense off smelling and tasting things. Caused from old age individuals can also have problems with their hearing. Organs:...
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