Neurocognitive Disorders

What is cognition?

The brain’s ability to process, retain, and use information including reasoning, judgment, perception, attention, comprehension, and memory.

What are neurocognitive disorders?

Disorders involving disruption or impairment in higher-level brain functions.

What is delirium?

A short-term, acute disturbance of consciousness with changes in memory, orientation, and language.

What causes delirium?

Infections, electrolyte imbalances, metabolic disturbances, hypoxia, medications, drug intoxication, or withdrawal.

What is the primary treatment for delirium?

Supportive measures and treating the underlying cause.

What motor changes are seen in delirium?

Hyperactive or hypoactive psychomotor behavior and possible speech problems.

What mood changes occur in delirium?

Rapid, unpredictable shifts between agitation and lethargy.

How is memory affected in delirium?

Recent memory is severely impaired with fragmented thoughts.

How is awareness affected in delirium?

Decreased awareness of the environment.

How is judgment in delirium?

Impaired judgment and insight.

What sleep changes occur in delirium?

Disturbed sleep-wake cycle.

What is the priority outcome in delirium?

Freedom from injury.

What intervention helps manage delirium confusion?

Use orienting cues, calm voice, and avoid sensory overload.

How do you promote basic needs in delirium?

Ensure sleep, nutrition, hydration, and safety.

Is there a specific medication for delirium?

No, treatment focuses on underlying cause and supportive care.

Is dementia progressive or acute?

Progressive cognitive impairment developing slowly over time.

What is executive dysfunction?

Difficulty with abstract thinking, planning, initiating, and sequencing tasks.

What is aphasia?

Difficulty with speech or language.

What is apraxia?

Difficulty performing movements on command despite intact motor function.

What is agnosia?

Inability to recognize objects or people.

What occurs in mild dementia?

Short-term memory loss, language difficulty, mood changes, and diminished judgment.

What occurs in moderate dementia?

Inability to retain new information, behavioral/personality changes, increased long term memory loss, wandering, agitation, aggression, confusion, requires ADL assistance

What occurs in severe dementia?

gait/motor disturbances, bedridden, unable to perform ADLs, incontinence, requires long term care placement

What genetic factor increases Alzheimer’s risk?

APOE-e4 gene.

How does head injury relate to Alzheimer’s?

Prior head injury increases risk.

How does metabolic syndrome contribute to Alzheimer’s?

Microvascular changes increase dementia risk.

What protein accumulates in Alzheimer’s?

Beta-amyloid protein.

Which neurotransmitters are reduced in Alzheimer’s?

Acetylcholine, norepinephrine, and serotonin.

Why is the patient history unreliable in dementia?

The client cannot accurately recall events.

What motor behaviors appear in dementia?

Aphasia, apraxia, and uninhibited behavior.

What mood is common early in dementia?

Depression.

What thought-content symptoms appear in dementia?

Delusions and visual hallucinations.

What is confabulation?

Unintentionally filling in memory gaps with fabricated information.

How is judgment in dementia?

Poor judgment.

How is self-concept affected in dementia?

Sadness early, eventual loss of self-awareness.

How does dementia affect relationships?

Profound role impairment and caregiver strain.

What physiological deficits appear in dementia?

Disturbed sleep, incontinence, hygiene deficits.

What are common delusions in dementia?

Infidelity, impostors, theft, strangers in home, TV people believed to be real.

What hallucinations are most common in dementia?

Visual hallucinations such as seeing people or creatures in the room.

What are key dementia interventions?

Safety, routine, hygiene support, sleep, nutrition, emotional support, social involvement.

Why is routine important in dementia?

It reduces confusion and anxiety.

How do nurses support emotions in dementia?

Provide reassurance, validation, and gentle redirection.

What lifestyle factors reduce Alzheimer’s risk?

Brain-stimulating activities, exercise in midlife, large social networks.

What do caregivers need?

Education, emotional support, respite care, support groups, agency help, personal time.

What self-awareness issues do nurses face with dementia?

Frustration, emotional strain, and grief for patients who won’t recover.

How should nurses manage frustration?

Discuss with mentor/supervisor and seek support.

Do Alzheimer’s medications cure the disease?

No, they only temporarily improve symptoms.

Which chemical is reduced in Alzheimer’s?

Acetylcholine.

How do cholinesterase inhibitors work?

They prevent acetylcholine breakdown to increase levels in the brain.

Why do cholinesterase inhibitors lose effect over time?

Progression causes further neuron loss and lower acetylcholine production.

What does Galantamine treat?

Mild to moderate Alzheimer’s.

How is Galantamine taken?

ER capsule daily or IR pill twice daily.

What does Rivastigmine treat?

Mild to moderate Alzheimer’s

What does Memantine treat?

Moderate to severe Alzheimer’s disease.

What does Namzaric treat?

Moderate to severe Alzheimer’s (donepezil + memantine).

What does Donepezil treat?

All stages of Alzheimer’s disease.

What are common side effects of Alzheimer’s meds?

Headache, dizziness, nausea, diarrhea.

How to reduce side effects of Alzheimer’s meds?

Start low, titrate slowly, take with food.