Transcript Chapter_21

Chapter 21
Cognitive Disorders
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Copyright © 2002 by W. B. Saunders Company. All rights reserved.
F
Mental health continuum for cognitive disorders
(Fig. 21-1)
Slide 21-2
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Copyright © 2002 by W. B. Saunders Company. All rights reserved.
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Interventions: Delirious Client
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Eliminate causative factors
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Monitor vital and neurological signs
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Call client by name and identify self
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Use face-to-face contact
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Use short, simple, concrete phrases
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Explain what’s to be done
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Keep room well lit
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Keep head of bed elevated
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Provide clocks, calendars
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Copyright © 2002 by W. B. Saunders Company. All rights reserved.
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F
Interventions: Delirious Client, cont.
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Have client wear glasses, hearing aids
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Provide continuity of personnel
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Clarify reality if hallucinations/illusions persist
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Ignore insults
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Set limits on physically abusive behavior
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F
Stages of Alzheimer’s Disease
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Stage 1 (Mild): Forgetfulness
- Usually not diagnosable
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Stage 2 (Moderate): Confusion
- Short term memory impairment
- ADLs decline
- In-home assistance needed
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Copyright © 2002 by W. B. Saunders Company. All rights reserved.
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F
Stages of Alzheimer’s Disease, cont.

Stage 3 (Severe): Ambulatory Dementia
- ADL losses
- Reasoning and verbal communication poor
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Stage 4 (Late): End Stage
- No recognition of family/self
- Nonambulatory
- Forgets how to eat/incontinent
- Institutionalized
B
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F
Problems in Dementia
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Memory impairment
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Disorientation, mistaken beliefs
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Needs physical help
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Risk for injury
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Apathy
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Poor Communication
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Repetitiveness
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Uncontrolled emotion, behavior
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Incontinence
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Poor decision making
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Burden on family
B
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
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