NUR-3412 Mental Health Nursing: Neurocognitive Disorders

Major Domains of Cognitive Function

• Complex attention: difficulty in environments with multiple stimuli
• Executive function: inability to perform complex projects
• Learning and memory: repeats conversation, often within the same conversation
• Language: significant difficulties with expressive or receptive language
• Perceptual – Motor: significant difficulties with previously familiar activities
• Social cognition: changes in behavior, showing insensitivity to social standards

Delirium

• Acute cognitive disturbance, often reversible condition
• Characterized by a disturbance in attention and awareness and a change in cognition
• Develops rapidly over a short period
• Epidemiology: most common complication of hospitalization, especially in older patients
• Comorbidity: always due to underlying physiological causes
• Etiology: multifactorial, including systemic infections, metabolic disorders, comorbid medical conditions, and more

Delirium - DSM 5 Diagnostic Criteria

• Rapid and abrupt onset of impaired attention and lack of awareness of environment
• Change in at least one cognitive domain, including impairment in recent memory, disorientation to time and place, language, and perceptual disturbance
• Associated features: change in sleep-wake cycle, change in emotional states

Delirium - Management

• Treat underlying causes
• Provide a consistent physical environment, daily routine, and caregivers
• Use environmental cues to stimulate memory, reorient, and promote appropriate behavior
• Communicate with simple, direct, descriptive statements
• Use physical restraints, as needed

Neurocognitive Disorders (NCDs)

• Include both delirium and major and mild neurocognitive disorders
• Characterized by a clinically significant deficit in cognition or memory, representing a significant change from a previous level of functioning

Alzheimer's Disease

• Characterized by memory loss that disrupts daily life
• Signs and symptoms include:
  • Misplacing things and losing the ability to retrace steps
  • Challenges in planning or solving problems
  • Difficulty completing familiar tasks
  • Confusion with time or place
  • Trouble understanding visual images and spatial relationships
  • New problems with words in speaking or writing
  • Decreased or poor judgment
  • Withdrawal from work or social activities
• Etiology: unknown, but several hypotheses have been supported, including genetics, biological, brain changes, head injury, and Down's syndrome
• Pharmacological interventions: symptomatic treatments, including acetylcholinesterase inhibitors (e.g., Aricept, Cognex, Exelon, Razadyne)

Test your knowledge of neurocognitive disorders, including delirium, etiological factors, clinical symptoms, and nursing interventions. This quiz covers the key concepts and treatment modalities for clients with neurocognitive disorders. It's a perfect study guide for nursing students in the College of Health Sciences Bachelor of Science in Nursing (BSN) Program.