neurocognitive disorders

neurocognitive disorders: a group of conditions with the disruption of what 4 things?

thinking, memory, processing, and problem-solving

major neurocognitive disorder (2)

AD and dementia

delirium (3)

confusion, disorientation, and unable to think/remember clearly

delirium onset and duration

abrupt onset (unless cause is systemic illness/metabolic imbalance); 1 week-1 month

primary NCDs and example

NCD not directly related to an illness; AD

secondary NCDs and examples (2)

caused by or r/t another illness; HIV or cerebral trauma

sx of NCDs (5)

impaired/abstract thinking/judgment/impulse control, inappropriate social conduct, inappropriate behavior, neglected personal appearance/hygiene, and personality changes

reversible NCD is aka

temporary dementia

with disease progression, sx include… (6)

aphasia, apraxia (can’t name/use objects correctly), irritability/moodiness, no care for personal needs, wandering, and incontinence

2 common findings in NCD

infections and eating problems

stage 1 AD

no apparent sx

stage 2 AD (2)

forgetfulness and short-term memory loss

stage 3 mild-cognitive decline AD (2)

change in reasoning/thinking, get lost driving home

stage 4 mild-mod cognitive decline AD (4)

cannot shop, cannot remember child’s bday, confabulation, and denial

stage 5 mod cognitive decline AD

cannot perform ADLs

stage 6 mod-severe cognitive decline AD (7)

cannot recall spouse’s name, calling child mother, don’t know person/place/time, aggression, wandering, incontinence, leave for work when retired

stage 7 severe cognitive decline AD (3)

unable to do anything for self, cannot recognize family members, bedfast

AD cause

plaques and tangles destroy neurons in the brain and increase in inflammatory mediators

most common neurobehavioral sx following head trauma

amnesia

repeated head trauma can result in what? sx? (4)

dementia pugilistica; labile, dysarthria, ataxia, and impulsive

prion disease cause? onset/progression? sx? (3)

infectious prions; slow onset and rapid progression; ataxia, movement disorders, and dementia

NCD diagnostic lab evaluations (2)

blood and urine

delirium drug treatments (2)

antipsychotics and benzos

3 physiological things to monitor for with delirium

F & E, hypoxia, and diabetes

NCD drugs for cognitive impairment (5)

-stigmine, tacrine, donepezil, galantamine, and memantine

donepezil: risk? when taken?

GI bleed with aspirin; night

NCD agitation/aggression/hallucinations/thought disturbances/wandering drugs (3), AE, and most common

-apine, -idone, and pimavancerin; EPS; ziprasidone

NCD drugs for sleep (6)

benzos, zolpidem, zaleplon, ramelteon, eszopiclone, and mirtazapine