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Nursing In a Flash 
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Question Answer
___________ is based on a system of interrelated abilities, such as perception, reasoning, judgment, intuition, and memory that allows one to be aware of oneself and one's surroundings.
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Cognition
What structure of the brain is essential to the transfer of some memories from short-term to long term storage?
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The hippocampus
_________ is a facet of cognition concerned with retaining and recalling past experiences.
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Memory
Impairments in _________ abilities can resilt in a failure of the afflicted person to recognize that he/she is ill and needs treatment.
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Cognitive
The underlying major difference between delirium and dementia is?.
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Delirium has an acute onset and dementia has an insidious onset.
________ dementia results from disease processes that globally affects the cortex like Alzheimers.
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Cortical dementia
Alzheimers is an example of _________ dementia.
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Cortical dementia
__________ dementia is caused by dysfunction or deterioration of deep gray or white matter structures inside the brain and brain stem.
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Subcortical
How can symptoms of subcortical dementia differ from cortical dementia?
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They can be more localized and tend to disrupt arousal, attention and motivation.
What is the key diagnostic criterion of delirium?
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Imparied consciousness: the patient is less aware of their environment, loses the ability to focus, sustain and shift attention and experiences problems in memory, orientation and language.
What is the priority for a patient experiencing delirium?
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Identifying and correcting the underlying cause.
What are common causes of delirium in children?
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Anticholinergic medications or fever
How does delirium manifest in children?
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Sleep-wake disturbances, fluctuating symptoms, impaired attention, irritability, agitation, mood lability and confusion.
What are the major differences between delirium and dementia?
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In dementia, the patient usually has a clear consciousness, can sustain attention, normal psychomotor activity and speech. In delirium, all those things are impaired.
Who is most likely to experience delirium?
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Post-operative elderly patients.
What is the greatest risk factor for developing delirium?
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Pre-existing cognitive impairment
What are risk factors for developing delirium?
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Severe illness, age, being male, alcohol abuse, lower levels of education attainment, fracture, depression or impaired vision.
What is the biological basis for most cases of delirium?
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An imbalance of key neurochemicals such as dopamine, serotonin, cortisol, acetylcholine, glutamate, and GABA.
What are the two primary aspects of managing delirium?
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Elimination or correction of the underlying cause and symptomatic and supportive measures
When determining the cause of delirium, what are some nursing interventions that should be done?
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Use of all suspected medications should be stopped and vital signs should be monitored every 2 hours at a minimum. Observe for changes in vital signs, behavior and mental status.
How can changes in elimination cause delirium?
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Constipation or diarrhea can disrupt fluid balance.
Sleep disturbances are a symptom of delirium. What should a nurse focus on in order to help?
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Restore a normal sleep cycle (extremely important) to prevent sleep deprivation and continuation/exacerbation of confusion.
Why should OTC medication use be evaluated in a patient with delirium?
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OTC medications, especially cold preparations taken in sufficient quantities, can cause delirium/confusion especially in older patients.
What are the primary interventions in the biologic domain for a patient with delirium?
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Providing a safe and therapeutic environment, maintaining F&E balance, providing adequate nutrition and prevention of decubitus ulcers and aspiration.
How can a patient with delirium be protected while in their hospital room?
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Use low beds, guardrails, and careful supervision, implement falls and delirium management precautions.
What medications are typically use to treat patients with delirium?
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Risperidone, and if the delirium is r/t alcohol withdrawal benzodiazepines.
What is the dosing rule r/t medications given to patients to treat delirium?
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Dosages are usually kept very low, especially with elderly patients and ideally it should be administered orally.
What are the drawbacks to using benzodiazepines to treat delirium?
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They can further impair cognition or cause a paradoxical agitation
What should be reported to the physician after administering medications to a patient experiencing delirium?
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Any changes or worsening of mental staus after administration of the medication.
When using antipsychotic medications to treat delirium, what adverse event should the nurse be vigilant for?
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Neuroleptic malignant syndrome (high fever, lead-pipe rigidity, changes in mental status and ANS changes).


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