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Nursing management of dementia ho

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NURSING MANAGEMENT OF DEMENTIA
Dementia is a general term that refers to progressive, degenerative brain dysfunction, including deterioration in
memory, concentration, language skills, and reasoning that interferes with a person’s daily functioning.
* More common in older adults than in younger persons.
* It is not considered a normal part of aging.
Delirium is an acute reversible disturbance of consciousness accompanied by a change in cognition not
attributed to pre-existing dementia lasting several hours or days.
Essential Features of Delirium are :
1. Disturbance of consciousness
2. Change in cognition such as memory deficit, language disturbance, or the development of
disorientation
3. That these changes are of recent onset and fluctuate during the course of the day
** Delirium usually arises due to a physiological consequence of a medical condition or medication. It
can often be resolved by altering external or internal factors.
Wiesenfield’s IN/OUT Approach:
Consider Causes IN the brain:
1. Stroke 2. Trauma
3. Meningitis 4. Vascular disorders
Consider Causes OUT of the Brain:
1. Endocrine dysfunction
2. Organ failure
3. Infections
4. Metabolic disorders
5. shock
6. Burns
7. Dehydration
8. Nutritional deficiencies
Consider Drugs Going IN the body:
1. Opiates
2. Anticholinergic medications
3. steroids
4. Psychoactive drugs
5. OTC Cold prepararions
Consider Drugs Going OUT of the Body:
1. Alcohol Withrawal
2. Sedative withrawal
3. Steroid Withrawal
In managing delirium, follow this mnemonic ADVISE
A Advocacy ( In this state, patients cannot speak for themselves and misdiagnoses are often made unless those
closest to the patients advocate for them.

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V Vigilance ( Once the treatment for the delirium begins, the practitioner needs to be very watchful of the
patient, monitoring response to treatment)
I Integration ( use all resources available to care for the patient. This means using the appropriate
pharmacology but also guiding and supporting the patient as the delirium subsides. It won’t happen all at once.,
and this can be very disturbing to the pt and his family.
S Support ( This is a very frightening experience for patients. They know something is not right. They feel the
disorientation and may be embarrased by what is happening.
E- Education. ( Throughout the process, help the family know what is happening. Once the delirium resolves,
carefully educate both the patient and the family as to the probable cause and how to avoid it in the future- esp
if the cause is medication related
Possible warning Signs of dementia:
1. Frequent forgetfulness, especially of recent events
2. Difficulty with common tasks ( ex. Cooking)
3. Forgetting common words
4. Becoming lost in familiar areas
5. Poor judgment especially with finances
6. Misplacing objects in unusual places ( puts clothes in bathtub)
7. Changes in mood, behavior or personality
8. Lack of interest/involvement in life activities
Risk Factors for Dementia:
1. Age
2. Family History
3. Genetic Factors
4. History of Head Trauma
5. Vascular disease
6. Certain types of infections
Diagnostic Criteria for Alzheimer’s Disease:
1. Multiple cognitive deficits/ impairment
> Impaired short or long term memory
> At least 1 of the following
a. Impaired executive function ( abstraction, planning, organizing, sequencing)
b. Aphasia ( language disturbance)
c. Apraxia (impaired purposeful movements)

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NURSING MANAGEMENT OF DEMENTIA Dementia is a general term that refers to progressive, degenerative brain dysfunction, including deterioration in memory, concentration, language skills, and reasoning that interferes with a person’s daily functioning. * More common in older adults than in younger persons. * It is not considered a normal part of aging. Delirium is an acute reversible disturbance of consciousness accompanied by a change in cognition not attributed to pre-existing dementia lasting several hours or days. Essential Features of Delirium are : 1. Disturbance of consciousness 2. Change in cognition such as memory deficit, language disturbance, or the development of disorientation 3. That these changes are of recent onset and fluctuate during the course of the day ** Delirium usually arises due to a physiological consequence of a medical condition or medication. It can often be resolved by altering external or internal factors. Wiesenfield’s IN/OUT Approach: Consider Causes IN the brain: 1. Stroke 3. Meningitis 2. Trauma 4. Vascular disorders Consider Causes OUT of the Brain: 1. 2. 3. 4. 5. 6. 7. 8. Endocrine dysfunction Organ failure Infections Metabolic disorders shock Burns Dehydration Nutritional deficiencies Consider Drugs Going IN the body: 1. 2. 3. 4. 5. Opiates Anticholinergic medications steroids Psychoactive drugs OTC Cold prepararions Consider Drugs Going OUT of the Body: 1. Alcohol Withrawal 2. Sedative withrawal 3. Steroid Withrawal In managing de ...
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This is great! Exactly what I wanted.

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