Multidimensional 4

Module 01 Assignment – Presentation on Dementia

1. Scenario
   As a manager on a medical surgical unit, part of the job responsibility includes chart audits.
   A trend noted during the most recent audit was the overuse of the term “dementia.” The nurse manager notes that there may be a lack of understanding between the types dementia as related to neurological diseases.
   The nurse manager developed a survey to evaluate the staff’s understanding of the different types of dementia. As a result of the survey, you have been asked to create a PowerPoint presentation to increase the nurse’s awareness of the types of dementia a presentation was created.
   Instructions
   Choose one of the following topics for a focused presentation:

   Alzheimer’s
   Parkinson’s
   Vascular Dementia
   The presentation should include the following:
   Pathophysiology
   Etiology & incidence
   Health promotion and maintenance
   History/Risk factors
   Physical signs and symptoms
   Changes in cognition
   Changes in behavior & personality
   Changes in self-management skills
   Diagnostics: laboratory and imaging assessment
   Planning and implementation
   Interprofessional Collaborative Care
   Psychosocial integrity
   Medications
   Safety considerations
   Using Ignatavicius and one additional resource, develop a presentation to enhance the nurses’ knowledge of the differences between types of dementia and delirium. Be sure to document your source(s) in your presentation.

Presented by
Margaret Smallwood

ALZHEIMER’S

Joseph Maximilien
Excellent presentation.

Joseph Maximilien
Always date your work.

Pathophysiology

Alzheimer’s disease produces a steady and
gradual decline of a client’s cognitive function.
Amyloid plaques containing fragments of
protein mix with neuron remnants, and other
nerve cell pieces. The neurofibrillary tangles,
found inside neurons, form a tau which clumps
together. Failure function and immobility of the
neurons leading to death. As the disease
progresses the client’s ability to learn new
information and will eventually impair language,
judgment, and behavior (Ignatavicius &
Workman, 2021).

Etiology

Alzheimer’s is caused by genetic and environmental factors
(viral). The amyloid plaques containing fragments of protein
mix with neuron remnants, and other nerve cell pieces. The
neurofibrillary tangles, found inside neurons, form a tau which
clumps together. Failure function and immobility of the neurons
leading to death. As the disease progresses the client’s ability
to learn new information and will eventually impair language,
judgment, and behavior. Neurons cannot survive when their
connections to other neurons are lost. As neurons die
throughout the brain, the affected regions begin to atrophy or
shrink. The damage is widespread and brain tissue has shrunk
significantly (Story, 2017).

Many Alzheimer’s clients have chronic
health problems such as diabetes mellitus,
strokes, and atherosclerosis.
Preventive methods such as smoking and
excessive alcohol consumption increase
the risk of stroke and cardiovascular
disease (Ignatavicius & Workman, 2021).

Health Promotion and Maintenance

Eating a well-balanced diet
Using soy products
Consuming sufficient amounts of folate and
vitamins B12, C, and E.
Walking and swimming
Other exercises not only increase tone and
muscle strength but also may decrease
cognitive decline. (Ignatavicius &
Workman, 2021).

Maintaining a healthy lifestyle such as:

Risk Factors / History

Female
Over 65 years of age
Down syndrome
Traumatic brain injury
chemical imbalances
Environmental agents
Immunologic changes
Excessive stress
Ethnicity/race.

Environmental agents such
as herpes zoster and
herpes simplex, and toxic
metals (zinc and copper)
increase the risk of AD.
Patients who have
experienced a traumatic
brain injury such as war
veterans or repeated head
trauma such as boxers may
experience AD at an early
age (Story, 2017)

Short-term memory impairment.
Alterations in communication such as apraxia, aphasia,
anomia, and agnosia.
Impaired judgment such as inability to make decisions,
decreased attention span, and decreased ability to
concentrate.

CHANGES IN COGNITION

Aggressiveness, especially verbal and physically abusive
tendencies.
Rapid mood swings
Increased confusion at night/sundowning or excessively
fatigued.
The client wanders and become lost / may go into other
rooms to rummage through anothers belonging.

CHANGES IN BEHAVIOR & PERSONALITY

Decreased interest in personal appearance.
Selection of clothing that is inappropriate for the weather
or event.
Loss of bowel and bladder control.
Decreased appetite or ability to eat (Ignatavicius &
Workman, 2021).

CHANGES IN SELF-MANAGEMENT SKILLS

Physical Signs and Symtoms

CT scan shows cerebral atrophy and
ventricular enlargement, wide sulci,
and shrunken gyri
MRI scan rule out other causes of the
neurological disease (Ignatavicius &
Workman, 2021).

Diagnostics

Genetic testing (apooliprotien E4 (APOE 4))
Amyloid beta-protein precursor (soluble)
(sBPP).

Laboratory Imaging assessment

Planning and Implementation

Interprofessional collaborative
Implement a structured and consistent plan of care and
environment.
Provide a complete evaluation and assistance in helping
the client become more independent.
Promote cognitive stimulation and memory training
such as interactive pet therapy.
Promoting bowel and bladder continence.
Promoting communication and self-management such
as communication board or digital handheld device for
scheduled activities.
Encourage the family to provide pictures of family and
friends that are labeled with the person’s name on the
pictures.
Encourage family and staff to frequently reorient the
patient such as “what day is it” (Ignatavicius &
Workman, 2021).

Psychosocial Integrity

The client experience the
grieving process; the client
anticipates loss, experiencing
denial, anger, bargaining, and
depression at varying times.
After diagnosis one or more
family members may desire
genetic testing.
Support the client and family’s
decisions regarding testing
Ensure the family finds credible
resources for testing and
professional genetics
counseling.

Help client with change in
routine and environment
since the client
experiences changes in
emotional and behavioral
affect.
The client experience
sexual disinhibition such as
masturbating publicly.
The client is unaware of
their behavior, therefore,
provide support to both
family and client
(Ignatavicius & Workman,
2021).

This drug blocks excess amount of
glutamate that can demage nreve
cells.
Helps maintain clients function for
few months longer.
Improve memory and thinking skills

For AD client who develop depression
SSRIs such as paroxetine and
sertraline

Memantine (Namenda):

Antidepressants :

Medications

This drug slows the onset of cognitive
decline.

These drugs are prescribed for clients
with mental/behavioral health
problems.
This drug should be used as a last
resort due to the decreasing mobility
and self management ability (Story,
2017)

Cholinesterase inhibitors: Aricept, Reminyl,
and Exelon

Psychotropic drugs such as antipsychotic
or neuroleptic

The client room should have adequate,
nonglare lighting and no potentially
lightening shadows.
A private room is needed if the client has
a history of agitation or wandering.
The television should remain off unless
the client turns it on or requests it on
When communicating with the client use
short sentences and one-step
instructions.
Never assume. that the client is totally
confused and can’t understand what is
being communicated.

Safety Considerations
Keep the client away from stairs or
elevators.
Avoid physical or chemical restraints
and assess and treat pain.
Place the client in an area that
provides maximum observation but not
in the nurse’s station.
Use family members, friends,
volunteers, and sitters as needed to
monitor the client.
Provide frequent toileting and
incontinence care as needed
(Ignatavicius & Workman, 2021).

Ignatavicius, D.D., & Workman, M.L.,
Rebar, C. & Heimgartner, N. M. (2021).
Medical-surgical nursing: Concepts for
interprofessional care (10th ed.). Elsevier.

Story, L. (20170301). Pathophysiology:
A Practical Approach, 3rd Edition.
[VitalSource Bookshelf 10.0.2].
Retrieved from vbk://9781284142983

References

Presented by
Margaret Smallwood

ALZHEIMER’S

Joseph Maximilien
Excellent presentation.

Joseph Maximilien
Always date your work.

Pathophysiology

Alzheimer’s disease produces a steady and
gradual decline of a client’s cognitive function.
Amyloid plaques containing fragments of
protein mix with neuron remnants, and other
nerve cell pieces. The neurofibrillary tangles,
found inside neurons, form a tau which clumps
together. Failure function and immobility of the
neurons leading to death. As the disease
progresses the client’s ability to learn new
information and will eventually impair language,
judgment, and behavior (Ignatavicius &
Workman, 2021).

Etiology

Alzheimer’s is caused by genetic and environmental factors
(viral). The amyloid plaques containing fragments of protein
mix with neuron remnants, and other nerve cell pieces. The
neurofibrillary tangles, found inside neurons, form a tau which
clumps together. Failure function and immobility of the neurons
leading to death. As the disease progresses the client’s ability
to learn new information and will eventually impair language,
judgment, and behavior. Neurons cannot survive when their
connections to other neurons are lost. As neurons die
throughout the brain, the affected regions begin to atrophy or
shrink. The damage is widespread and brain tissue has shrunk
significantly (Story, 2017).

Many Alzheimer’s clients have chronic
health problems such as diabetes mellitus,
strokes, and atherosclerosis.
Preventive methods such as smoking and
excessive alcohol consumption increase
the risk of stroke and cardiovascular
disease (Ignatavicius & Workman, 2021).

Health Promotion and Maintenance

Eating a well-balanced diet
Using soy products
Consuming sufficient amounts of folate and
vitamins B12, C, and E.
Walking and swimming
Other exercises not only increase tone and
muscle strength but also may decrease
cognitive decline. (Ignatavicius &
Workman, 2021).

Maintaining a healthy lifestyle such as:

Risk Factors / History

Female
Over 65 years of age
Down syndrome
Traumatic brain injury
chemical imbalances
Environmental agents
Immunologic changes
Excessive stress
Ethnicity/race.

Environmental agents such
as herpes zoster and
herpes simplex, and toxic
metals (zinc and copper)
increase the risk of AD.
Patients who have
experienced a traumatic
brain injury such as war
veterans or repeated head
trauma such as boxers may
experience AD at an early
age (Story, 2017)

Short-term memory impairment.
Alterations in communication such as apraxia, aphasia,
anomia, and agnosia.
Impaired judgment such as inability to make decisions,
decreased attention span, and decreased ability to
concentrate.

CHANGES IN COGNITION

Aggressiveness, especially verbal and physically abusive
tendencies.
Rapid mood swings
Increased confusion at night/sundowning or excessively
fatigued.
The client wanders and become lost / may go into other
rooms to rummage through anothers belonging.

CHANGES IN BEHAVIOR & PERSONALITY

Decreased interest in personal appearance.
Selection of clothing that is inappropriate for the weather
or event.
Loss of bowel and bladder control.
Decreased appetite or ability to eat (Ignatavicius &
Workman, 2021).

CHANGES IN SELF-MANAGEMENT SKILLS

Physical Signs and Symtoms

CT scan shows cerebral atrophy and
ventricular enlargement, wide sulci,
and shrunken gyri
MRI scan rule out other causes of the
neurological disease (Ignatavicius &
Workman, 2021).

Diagnostics

Genetic testing (apooliprotien E4 (APOE 4))
Amyloid beta-protein precursor (soluble)
(sBPP).

Laboratory Imaging assessment

Planning and Implementation

Interprofessional collaborative
Implement a structured and consistent plan of care and
environment.
Provide a complete evaluation and assistance in helping
the client become more independent.
Promote cognitive stimulation and memory training
such as interactive pet therapy.
Promoting bowel and bladder continence.
Promoting communication and self-management such
as communication board or digital handheld device for
scheduled activities.
Encourage the family to provide pictures of family and
friends that are labeled with the person’s name on the
pictures.
Encourage family and staff to frequently reorient the
patient such as “what day is it” (Ignatavicius &
Workman, 2021).

Psychosocial Integrity

The client experience the
grieving process; the client
anticipates loss, experiencing
denial, anger, bargaining, and
depression at varying times.
After diagnosis one or more
family members may desire
genetic testing.
Support the client and family’s
decisions regarding testing
Ensure the family finds credible
resources for testing and
professional genetics
counseling.

Help client with change in
routine and environment
since the client
experiences changes in
emotional and behavioral
affect.
The client experience
sexual disinhibition such as
masturbating publicly.
The client is unaware of
their behavior, therefore,
provide support to both
family and client
(Ignatavicius & Workman,
2021).

This drug blocks excess amount of
glutamate that can demage nreve
cells.
Helps maintain clients function for
few months longer.
Improve memory and thinking skills

For AD client who develop depression
SSRIs such as paroxetine and
sertraline

Memantine (Namenda):

Antidepressants :

Medications

This drug slows the onset of cognitive
decline.

These drugs are prescribed for clients
with mental/behavioral health
problems.
This drug should be used as a last
resort due to the decreasing mobility
and self management ability (Story,
2017)

Cholinesterase inhibitors: Aricept, Reminyl,
and Exelon

Psychotropic drugs such as antipsychotic
or neuroleptic

The client room should have adequate,
nonglare lighting and no potentially
lightening shadows.
A private room is needed if the client has
a history of agitation or wandering.
The television should remain off unless
the client turns it on or requests it on
When communicating with the client use
short sentences and one-step
instructions.
Never assume. that the client is totally
confused and can’t understand what is
being communicated.

Safety Considerations
Keep the client away from stairs or
elevators.
Avoid physical or chemical restraints
and assess and treat pain.
Place the client in an area that
provides maximum observation but not
in the nurse’s station.
Use family members, friends,
volunteers, and sitters as needed to
monitor the client.
Provide frequent toileting and
incontinence care as needed
(Ignatavicius & Workman, 2021).

Ignatavicius, D.D., & Workman, M.L.,
Rebar, C. & Heimgartner, N. M. (2021).
Medical-surgical nursing: Concepts for
interprofessional care (10th ed.). Elsevier.

Story, L. (20170301). Pathophysiology:
A Practical Approach, 3rd Edition.
[VitalSource Bookshelf 10.0.2].
Retrieved from vbk://9781284142983

References