Mental impairments can be devastating for patients and family members.

At first patients with AD will experience forgetfulness and impaired judgment. Over several years the patient may become progressively worse. Becoming more and more confused, wandering which could lead to falls due to unfamiliar surroundings. In the beginning the patient may not require any nursing cars. As the patient becomes worse they will acquire advanced nursing care. From just assistance with activities for daily living to complete physical care.
1

NCLEX Questions
Mr. Jones has been having difficulty finding his way home from church This is a sign of Alzheimers disease. (circle) True / False 2. Genetic mutation of chromosome 19 is known to cause A. Dementia B. Early-Onset AD C.. Early-Onset Familiar AD D. L ate-Onset AD 3. The primary cause of Alzheimers disease is, (are) A. Tangles B. Plaques C. A and B D. None of the above 4. A person who has Alzheimers will show signs) : A. Memory Loss B. Mood Swings C. Poor hygiene D. All of these Answers to questions 1. True 2. D 3. C 4. D References Alzheimers Association . (2013). alz.org Huether, S. E., & McCance, K. L. (2012). Alterations in Cognitive System, Cerebral Hemodynamics. In Understanding Pathophysiology (5th ed.). St. Louis, Missouri: Elsevier. Ladwig, G. B., & Ackley, B. J. (2009-2011). Guide to nursing Diagnosis (3rd ed.). Maryland Heights, Missouri: Mosby . Mark, R. E., & Sitskoom, M. M. (2013). Are subjective cognitive complaints relevant in preclinical Alzheimers disease? A review and

Alzheimers Disease
(AD)

Ethical responsibilities would include being an advocate for the patient. Keeping the patients best interest at the for front of care, individual patient focused care. Being sure to include them and family members when making plans of care. Educating the patient and family members of what to expect and how to handle difficult situations.

guidelines for healthcare professionals. Reviews in Clinical Gerontology. http://dx.doi.org/10.1017/S0959259812000172 Plassman, PhD, B. L., Williams Jr., MD, MHSc, J. W., Burke, MD, PhD, J. R., Holsinger, MD, T., & Benjamin, MD, S. (2010, April 13, 2013). Medicine Systematic Review: Factors Associated with Risk for and Possilbe Prevention for Congnitive Decline Later in Life . Annals of Internal Medicine , 53, 182-193. Retrieved from http://annals.org

Causes are unknown Most common cause of severe cognitive dysfunction in older people Leading cause of dementia

There are three forms of AD

Audra Brooks Nursing 300 Professor Bishop

Early Onset AD (vary rare) Early Onset Familiar AD (FAD) Late Onset AD (most common)

Pathophysiology
This is a neurological disease. That is linked to genetic mutations on chromosome 21 (EarlyOnset AD) Familiar (FAD) and chromosome 19 (Late-Onset AD). FAD is most often found in individuals 40-50 years of age. Individuals who are 60 years and older are found to have LateOnset AD. In AD nerve cells (neurons) lose their ability to communicate with each other by a build up of proteins fragments beta amyloid also known as plaques. These plaques build up between nerve cells and interfere with the communication with each other. Another cause of nerve cell death are by what is called tangles. These tangles are called tau and build up inside the cells.

This disease is not a normal part of aging. It is a progressive disease that worsens overtime. The individual have memory loss that interferes with normal tasks of daily living. These could include not remembering how to get home from the store, simple math calculations. The average length of survival is three to nine years. May also be gradual with taking 20 years to run its course.

Clinical Manifestations

Memory Loss Confusion / Disorientation Behavior Changes / Mood Swings Loss of ability to concentrate Poor Hygiene

Diagnosis

Complete Medical History Mental Status Evaluation Physical and Neurological Exam Test (Cat Scan, MRI, Brain Imaging, and Blood

Latinos and African Americans have and increased rick for developing AD due to their increased rate of vascular disease.

tests There are many health care professionals involved in the care of individuals with AD. These include primary physician, neurologists, lab technicians, nurses, certified nurse assistants, radiologists and dieticians just to mention a few.

Nursing Diagnosis
Fear Related to Loss of Self Impaired memory related to neurological disturbance Powerlessness related to deteriorating condition

Risk Factors

Most common in age 65 or older Family History (Genetics and environmental factors) Head Trauma Heart /Head connection There is no cure for AD, but there are treatments for the symptoms. These may include diet, exercise, medications, and behavior therapy.

Nursing Outcomes
Identify, verbalize and demonstrate those coping behaviors the reduce own fear Verbalize known fears Demonstrate use of techniques to help with memory loss Participate in planning and implementing care Ask question about treatment State feelings over powerlessness and other feelings related to anger, sadness, and hopelessness

(Damage to heart and vessels has shown an increase with diagnosis of AD)