Question

Mr. White, age 68, suffers from Alzheimer's disease. He is able to understand simple commands and follow them. His speech is brief, hesitant, and garbled. It takes a long time for him to say anything. He often shakes his head and pause when trying to think of words. He often repeats the phrase, "Help me, help me." At times he becomes very frustrated when he can not make his wishes known to his family or the staff. He spends much of his time alone in his room and has been observed crying after a particularly frustrating visit with his family.
1. List three assessments related to Mr. Whites disease.
2.Define Alzheimer's disease including signs/symptoms/diagnosis and treatment.
3.List four nursing interventions for the client with Alzheimer's disease.

Answer 1

1.Three assessments for the patient are

Cognitive assessment like

Memories (Assessed by the patients wife or relatives), Speaking ability and thinking ability with visual and spatial abilities coordinatiion and motor functions and orientations etc

Psychological assessment by seeing personality depression level anxiety state inappropriate behaviour paranoia hallu cinations etc

Laboratory assessment like computed tomography magnetic resonance imaging single-photon emission CT or positron emission tomography [PET]) and laboratory tests

2.Dementia defines a group of symptoms affecting memory with thinking ability as well as social and behavioural inability interfaring with daily life,Though there are other causes of dementia Alzheimer's disease is the most common cause of a progressive dementia in aging population .

Sign and symptoms

Insidiously progressive memory loss is the commonest presentation  defective cognition over several years. This loss may be associated with slowly progressive behavioral changes. After memory loss occurs, patients may also experience language disorders (eg, aphasia or anomia) and impairment in their visuospatial skills and executive functions.

Diagnosis and treatment

Slowly progressive memory loss, ( insidious onset ) in a fully conscious patient. AD cannot be diagnosed in patients with delirium or whose consciousness is suboptimal. Toxic metabolic conditions and brain tumors  also be excluded as causes of the patient’s dementia.

Major or mild neurocognitive disorder of insidious onset and gradual progression of impairment in one or more cognitive domains should be the criteria for diagnosis

Treatment.........

Donepezil is an oral medication belongs to a class of drugs called cholinesterase inhibitors .

scientists are in search of a drug that can slow or reverse the progression of AD ........... these drugs should produce  beta-amyloid, aggregation, and clearance, as well as tau phosphorylation and assembly. still now no such therapy is available except an antiamyloid agent in patients with early AD.The agent, BAN2401, was found to significantly reduce brain amyloid at high doses.

Antidepressants or psychiatric drugs are of no better use and their side effects are also there.

nursing interventions

To cope with the Complex physiological needs of the patient..................

To assess and promote behavioural functioning of the patients

Promoting safety

Using the health system for delivering care of the patient