Delirium and Dementia Overview

This set of flashcards covers key concepts related to delirium and dementia, encompassing definitions, symptoms, treatment approaches, and nursing considerations.

Delirium

An acute, reversible condition characterized by a sudden change in mental status, including confusion, disorientation, and impaired attention.

Neurotransmitter Imbalance

Disturbances in the brain’s neurotransmitter balance, specifically decreased acetylcholine and increased dopamine, affecting cognition.

Acetylcholine (ACh)

A neurotransmitter essential for attention, memory, and learning; reduced levels impair cognition and alertness.

Dopamine

A neurotransmitter whose excess leads to overactivity of the brain, causing hallucinations and agitation.

Cytokines

Proteins released during systemic inflammation that can affect neurotransmission and lead to altered mental status.

Inflammatory Response

The body's response to injury or infection that may trigger cytokine release, affecting brain function.

Cerebral Perfusion

The delivery of oxygen and glucose to the brain; impaired perfusion can lead to cognitive impairment.

Hypoglycemia

Low blood sugar that can contribute to delirium by directly affecting brain function.

Hypernatremia

An elevated sodium level that can impact brain health and contribute to delirium.

Hyperactive Delirium

A form of delirium with overt symptoms like agitation and hallucinations, often distressing for caregivers.

Hypoactive Delirium

A less recognized type of delirium characterized by lethargy and decreased motor activity, often mistaken for depression.

Mixed Delirium

A combination of hyperactive and hypoactive symptoms that fluctuate throughout the day.

Sudden Onset of Confusion

A characteristic symptom of delirium, appearing abruptly—often within hours to days.

Hallucinations

Seeing or hearing things that are not there, commonly associated with delirium.

Sleep Disturbances

Altered sleep patterns, such as reversed sleep-wake cycles, seen in delirium.

ICU Delirium

Delirium that occurs in critically ill patients, often due to sensory deprivation or sedative medications.

Polypharmacy

The concurrent use of multiple medications that increases the risk of drug interactions and delirium.

Old Age

A significant risk factor for delirium due to increased vulnerability to metabolic and drug effects.

Neurocognitive disorder

A major category that includes dementia, characterized by cognitive decline affecting daily life.

Alzheimer’s Disease

A progressive neurodegenerative disease that affects memory and cognitive function.

Amyloid Plaques

Clumps of protein that block communication between brain cells, associated with Alzheimer’s Disease.

Neurofibrillary Tangles

Twisted tau protein fibers inside neurons that disrupt nutrient transport in the brain.

Cholinesterase Inhibitors

Medications like Donepezil that increase acetylcholine levels to help with memory in dementia.

NMDA Antagonists

Drugs like Memantine that regulate glutamate to help slow the progression of Alzheimer’s Disease.

Vascular Dementia

A form of dementia caused by strokes leading to sudden or stepwise cognitive decline.

Lewy Body Dementia

Dementia characterized by visual hallucinations, Parkinson-like symptoms, and fluctuating alertness.

Frontotemporal Dementia

Affects younger adults, leading to personality changes and difficulties with language and behavior.

Sundowning

A phenomenon where individuals with dementia experience increased confusion and agitation in the late afternoon or evening.

CAM Diagnostic Features

Features used to diagnose delirium, including acute onset and fluctuation in attention and consciousness.

MMSE (Mini-Mental State Exam)

A cognitive screening tool that assesses orientation, memory, attention, and language.

MoCA (Montreal Cognitive Assessment)

A more sensitive cognitive screening tool for early dementia or mild cognitive impairment.

Environmental Adjustments

Modifications made to the patient's environment to reduce confusion and agitation.

Reorientation Techniques

Methods to help patients recognize time, place, and people to reduce disorientation.

Hydration & Nutrition

Ensuring adequate fluid intake and dietary needs for individuals at risk of delirium.

Frequent Monitoring

Regular assessment of cognitive function and behavioral changes to identify fluctuations in delirium.

Patient Education

Teaching patients and caregivers about delirium, its signs, and preventive measures.

Therapeutic Procedures

Interventions such as reminiscence therapy and reality orientation to support patients with dementia.

Risk Factors for Alzheimer’s

Non-modifiable factors include age above 65, family history of dementia, and genetics.

Safety Measures in Dementia Care

Strategies include fall prevention, maintaining routines, and supporting independence in activities of daily living.

Antipsychotics in Delirium

Used cautiously for severe agitation or hallucinations; may include Haloperidol or atypical antipsychotics.

Nursing Diagnoses for Delirium

Common diagnoses include Acute Confusion and Risk for Injury related to impaired cognition.

Clinical Assessment

The process of evaluating a patient's cognitive status and identifying changes from their baseline.

Cognitive Tests

Assessments that help in diagnosing dementia, such as MMSE and MoCA.

Laboratory Tests for Delirium

Tests used to identify underlying causes, including blood glucose and electrolyte levels.

Vitamin Deficiencies

Deficiencies in B12 or folate can affect cognition and mimic dementia.

Environmental Modifications

Adjustments like labeling and using signs to aid memory and reduce confusion.

Communication Techniques

Methods used to effectively interact with dementia patients, such as simple instructions and calm voice.

Health Promotion Strategies

Encouraging cognitive stimulation and a heart-healthy diet as part of dementia prevention.

Medication Safety in Elderly

Importance of monitoring medications to prevent adverse drug reactions in older adults.

Role of Caregivers

Support for individuals with dementia, helping with daily tasks and managing behavioral symptoms.

Cognitive Screening Importance

Regular assessments can help in early identification and management of cognitive decline.

Aggressive Behavior Management

Use of redirection and validation therapy to address aggression in patients with dementia.

End-of-life Care in Dementia

Focus on comfort and dignity in advanced stages of dementia where independence is lost.

Social Engagement Activities

Encouraging participation in social activities to enhance quality of life for dementia patients.

Routine Maintenance

Establishing and maintaining a daily routine to provide stability for individuals with cognitive impairment.

Hydration Management

Importance of frequent fluid intake to prevent dehydration in confused patients.

Medication Classes in Dementia Treatment

Includes cholinesterase inhibitors and NMDA antagonists to manage cognitive symptoms.

Symptoms of Alzheimer's Disease

Include memory loss, disorientation, mood swings, and difficulty with routine tasks.

Prevention Strategies for Dementia

Encouragement of regular exercise, healthy diets, and cognitive activities to minimize risk.

Role of Music Therapy

Utilized in dementia care to reduce agitation and improve mood among patients.

Reminiscence Therapy

Therapy using past memories to connect with patients, enhancing their engagement and comfort.

Community Resources for Caregivers

Support services available for caregivers to help manage stress and provide better care.

Validity of Cognitive Screening Tools

Emphasis on credible tools like MMSE and MoCA in diagnosing cognitive impairment.

Acetylcholine Function

Crucial neurotransmitter in memory and learning processes, often decreased in dementia.

Neuronal Changes in Dementia

Include loss of neurons, brain atrophy, and neurotransmitter imbalances.

Addressing Delirium Causes

Focus on treating infections, medication side effects, and metabolic imbalances.

Patient-Centered Care Approaches

Engagement with patients in their care, respecting their preferences and routines.

Behavioral Symptoms in Dementia

Symptoms such as aggression, agitation, and confusion that require careful management.

Long-term Planning for Dementia Patients

Ensuring safety and quality of life for individuals as their condition progresses.

Diagnosis and Ruling Out Other Conditions

Solutions for identifying dementia while excluding other medical issues.

Therapeutic Education for Families

Support and resource education provided to the families of dementia patients.

Importance of Early Recognition

Identifying early symptoms of delirium and dementia can lead to better outcomes.

Caregiver Support Systems

Resources available to caregivers, including respite care and educational materials.

Non-Pharmacological Interventions

Methods like environmental adjustments to reduce confusion and agitation.

Detecting Delirium Symptoms

Crucial for timely management and intervention strategies.

Complications from Delirium

Can lead to longer hospital stays and increased mortality if not addressed.

Assessment of Mental Status

Comparison to a patient's baseline to identify cognitive shifts or disturbances.

Consistent Reorientation Practices

Used to help individuals regain a sense of time and place amidst confusion.

Environmental Safety Adjustments

Modifications in a patient’s room to ensure their safety and comfort.

Individualized Care Plans

Tailoring care strategies to the specific needs of each dementia patient.

Factors Influencing Cognition

Includes age, comorbidities, and environmental aspects affecting mental health.

Optimal Use of Antipsychotics

Guidelines for safe use in managing severe symptoms in dementia patients.

Family Involvement in Care

Encourage family participation in treatment and routine care planning.

Supporting Patient Independence

Encouraging self-sufficiency in daily activities as long as safe.

Monitoring Cognitive Function

Regular assessments required to track changes and adapt care as needed.

Key Signs of Dementia Progression

Observation of increased memory loss and functional decline over time.

Patient Engagement Strategies

Promoting interaction and communication techniques to support cognitive function.

Risk Communication to Families

Discuss potential risks associated with aging and cognitive decline with families.

Promoting Safe Environments

Creating spaces that reduce risks for individuals with cognitive impairments.

Collaborative Care Approach

Involvement of multidisciplinary teams to provide comprehensive care for dementia patients.

Impact of Social Isolation

Understanding how loneliness can exacerbate symptoms of dementia.

Encouraging Family Memory Sharing

Involving family in reminiscing activities to strengthen connections with dementia patients.

Response to Delirium Interventions

Tracking effectiveness of treatments aimed at alleviating delirium symptoms.

Nutritional Considerations in Dementia Care

Focusing on dietary needs to support cognitive health and overall well-being.

Understanding Dementia Myths

Clarifying misconceptions about dementia and fostering accurate knowledge.

The Role of Support Groups

Providing emotional and practical support for caregivers navigating dementia care.

Implementing Behavioral Strategies

Using redirection and validation to manage challenging behaviors in dementia.

Environmental Cues for Memory Aid

Using signs and colors to assist patients with orientation and recall.

Adaptations for Hospitalized Patients

Creating a comforting setting to prevent confusional episodes during hospital stays.

Establishing Routine in Care

Maintaining consistency in daily activities to lessen anxiety for dementia patients.