The document discusses cognitive disorders including delirium, dementia, and amnestic disorders, outlining their symptoms, causes, assessments, and treatment approaches. Several types of dementia are described such as Alzheimer's disease, vascular dementia, and Parkinson's disease. Nursing interventions focus on promoting safety, adequate nutrition and hygiene, emotional support, and structured routines.
The world’s population is ageing rapidly, and with it is coming to a significant increase in the number of
older people with dementia. This increase presents major challenges for the provision of healthcare
generally and for dementia care in particular, for as more people have dementia, there will be more
people exhibiting behavioural and psychological symptoms of dementia (BPSD).
BPSD exact a high price from both the patient and the caregiver in terms of the distress and disability
they cause if left untreated. BPSD is recognisable, understandable and treatable. The recognition and
appropriate management of BPSD are important factors in improving our care of dementia patients
and their caregivers,
Presentation delivered by Dr. Carol Manning at the live webinar hosted by AlzPossible at www.alzpossible.org on the 17th of March, 2014.
www.alzpossible.org
The world’s population is ageing rapidly, and with it is coming to a significant increase in the number of
older people with dementia. This increase presents major challenges for the provision of healthcare
generally and for dementia care in particular, for as more people have dementia, there will be more
people exhibiting behavioural and psychological symptoms of dementia (BPSD).
BPSD exact a high price from both the patient and the caregiver in terms of the distress and disability
they cause if left untreated. BPSD is recognisable, understandable and treatable. The recognition and
appropriate management of BPSD are important factors in improving our care of dementia patients
and their caregivers,
Presentation delivered by Dr. Carol Manning at the live webinar hosted by AlzPossible at www.alzpossible.org on the 17th of March, 2014.
www.alzpossible.org
A presentation about depressive disorder. The presentation composed of the definition, causes, types, clinical feature, diagnosis, prognosis, treatment and prevention of depression
A presentation about depressive disorder. The presentation composed of the definition, causes, types, clinical feature, diagnosis, prognosis, treatment and prevention of depression
Quick review of the essential points— DSM5 diagnosis criteria, assessments, treatments—of these disorders to better prepare for the National Clinical Mental Health Counseling Exam. This was informed by several exam prep programs, and can be used like flashcards or as a presentation.
Definition, epidemiology, classifications based on etiology and site of involvement, stage of dementia, clinical signs and symptoms, investigations and management
common ask question:
Is memory loss a natural part of ageing?
Why can’t I remember as well as my wife?
Is it normal to write notes to myself?
Why can’t I remember names?
Is it normal to forget why I went into the kitchen?
Sometimes my mind just goes blank, normal?
Can I slow age related memory changes?
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
2. COGNITION
The brain’s ability to
process, retain, and use
information.
Include:
reasoning, judgment, perc
eption, attention, compreh
ension, and memory.
3. COGNITIVE DISORDER
Is a disruption or impairment in the
higher- level functions of the brain.
Devastating effects on the ability to
function in daily life.
Can cause people to forget the
names of the family members, to
be unable to perform daily
tasks, and to neglect personal
hygiene.
5. DELIRIUM
A syndrome that involves a disturbance of
consciousness accompanied by a change in
cognition.
Usually develops over a short
period, sometimes a matter of hours, and
fluctuates, or changes, throughout the
course of the day.
Clients have difficulty paying attention, are
easily distracted and disoriented, and may
have sensory disturbances such as
illusions, misinterpretations, or
hallucinations.
6. 10%- 15% people in the hospital with
general medical conditions are delirious at
any given time.
30%- 50% of acutely ill older adult clients
at some time during their hospital stay.
Risk factors: increased severity of physical
illness, older age, and baseline cognitive
impairment such as that seen in dementia.
Children may be more susceptible (febrile
and medications)
8. SYMPTOMS
Difficulty with attention
Easily distractable
Disoriented
May have sensory disturbances such as
illusions, misinterpretations, or
hallucinations
Can have sleep- wake cycle disturbances
Changes in psychomotor activity
May experience
anxiety, fear, irritability, euphoria, or apathy
9. TREATMENT
Primary treatment: identify
and any causal or
contributing medical
conditions.
10. Psychopharmacology
Need no specific medication aside
from that indicated to the specific
condition.
Antipsychotics: Haloperidol
(Haldol), 0.5- 1 mg. To decrease
agitation.
Adequate food and fluid intake
IV fluids or TPN
11. NURSING MANAGEMENT
Client’s safety is a priority.
Meet their physiologic and
psychologic needs.
Behavior, mood, and level of
consciousness of these clients
can fluctuate rapidly throughout
the day.
12. DEMENTIA
A mental disorder that involves multiple
cognitive deficits, primarily memory
impairment, and at least one of the
following disturbances:
Aphasia: deterioration of language function.
Apraxia: inability to execute motor functions
despite intact memory abilities.
Agnosia: inability to recognize or name
objects despite intact sensory abilities.
13. Disturbance in executive functioning, which is
the ability to think abstractly and to
plan, initiate, sequence, monitor, and stop
complex behavior.
Cognitive deficits must be sufficiently
severe to impair social or occupational
functioning and must represent a decline
from previous functioning.
MEMORY IMPAIRMENT: the prominent
early sign.
Recent memory first before remote memory
14. Aphasia
Usually begins with the inability to name
familiar objects or people and then
progresses to speech that becomes vague
or empty with excessive use of terms such
as “it” or “thing.”
May exhibit:
Echolalia: echoing what is heard
Palilalia: repeating words or sounds over and
over
15. Apraxia: May cause clients to lose
the ability to perform routine self-care
activities such as dressing or
cooking.
Agnosia: may be frustrating for
clients.
Disturbances in executive
functioning: evident due to inability to
learn new material, solve
problems, or carry out daily activities.
16. DSM-IV-TR DIAGNOSTIC CRITERIA
Loss of memory (initial stages, recent
memory loss; later stages, remote memory
loss).
Deterioration of language function
(forgetting names of common objects such
as chair or table, palilalia, and echolalia)
Loss of ability to think abstractly and to
plan, initiate, sequence, monitor or stop
complex behaviors (loss of executive
function).
17. Onset and Clinical Course
Mild: forgetfulness (hallmark of
beginning, mild, dementia). It exceeds
the normal, occasional forgetfulness
as part of the aging process.
Difficulty finding words, frequently loses
objects, and feels anxious about these
losses
Occupational and social settings are less
enjoyable, may avoid them
18. Moderate: confusion is
apparent, along with progressive
memory loss.
Can no longer perform complex tasks
but remains oriented to person and
place.
Still recognizes familiar people.
Toward the end of the stage, the person
loses the ability to live independently
and requires assistance because of
disorientation to time and loss of
information such as address and
19. Severe: personality and
emotional changes.
May be delusional, wander at
night, forget the name of his
spouse and children, and
require assistance in ADLs.
Usually lives in nursing facilities
when they reach this stage.
20. Etiology
Causes vary, although the clinical picture
is similar for more dementias.
Often, no definitive diagnosis can be made
until completion of postmortem
examination.
Metabolic activity is decreased in the
brain.
Genetic component for some forms:
Huntington
Infections: HIV, Creutzfeldt-Jacob disease
22. Alzheimer’s disease
Progressive brain disorder that has a
gradual onset but causes an increasing
decline of functioning, including loss of
speech, loss of motor function, and
profound personality and behavioral
changes such as
paranoia, delusions, hallucinations, inatten
tion to hygiene, and belligerence.
Evidenced by: atrophy of cerebral
neurons, senile plaque deposits, and
enlargement of the third and fourth
23. Risk increases with age; average duration
from onset of symptoms to death is 8- 10
years.
Dementia of Alzheimer’s type, especially
with late onset (after 65 years of age), may
have a genetic component.
Shown links to chromosomes 21, 14, and
19.
24. Vascular dementia
Symptoms similar to AD, but onset is
typically abrupt, followed by rapid changes
in functioning; a plateu, or levelling-off
period; more abrupt changes; more abrupt
changes; another levelling-off period; and
so on.
CT or MRI usually shows multiple vascular
lesions of the cerebral cortex and
subcortical structures resulting from the
decreased blood supply to the brain.
25. Pick’s disease
Degenerative brain disease that
particularly affects the frontal and temporal
lobes and results in a clinical picture
similar to that of AD.
Early signs: personality changes, loss of
social skills and inhibitions, emotional
blunting and language abnormalities.
Onset: 50- 60 years old; death: 2-5 years
26. Creutzfeldt- Jakob Disease
CNS disorder that typically develops in
adults 40-60 years old.
Involves altered vision, loss of
coordination or abnormal movements, and
dementia that usually progresses (a few
months).
Cause: infectious particle resistant to
boiling, UV radiation, and some
disinfectants.
27. HIV infection
Can lead to dementia and other neurologic
problems.
May result directly from an invasion of
nervous tissue by HIV or from other
acquired immuno-deficiency illnesses such
as taxoplasmosis and cytomegalovirus.
May result in a wide variety of symptoms
ranging from mild sensory impairment to
gross memory and cognitive deficits to
severe muscle dysfunction.
28. Parkinson’s disease
Slowly, more progressive
condition chracterized by
tremor, rigidity, bradykinesia, and
postural instability.
Results from loss of neurons of
the basal ganglia.
20%-60% has dementia
29. Huntington’s Disease
An inherited, dominant gene disease that
primarily involves cerebral
atrophy, demyelination, and enlargement
of brain ventricles.
Initially, there are choreiform movements
that are continuous during waking hours
and involve facial contortions, twisting, and
turning, and tongue movements.
30. Personality changes are the initial
psychosocial manifestations, followed by
memory loss, decreased intellectual
functioning, and other signs of dementia.
Begins in the late 30s or 40s and may last
10-20 years or more before death.
31. Head Trauma
Dementia can be a direct pathophysiologic
consequence.
Degree and type of cognitive impairment
and behavioral disturbance depend on the
location and extent of the brain injury.
When it occurs as a single injury, the
dementia is usually stable rather than
progressive. Repeated head injury may
lead to progressive dementia.
32. Treatment and Prognosis
Underlying cause is identified so that
treatment can be instituted.
Improvement of blood flow may arrest the
progress of vascular dementia in some
people.
Degenerative dementias: no treatment
have been found to reverse or retard the
fundamental physiologic processes.
34. Assessment
Mental Status Exam
History: family, friends, or care givers
General appearance and motor behavior:
Aphasia: cannot name familiar objects or
names
Apraxia loss of ability to perform tasks
Uninhibited behavior: inappropriate
jokes, neglecting personal hygiene, showing
undue familiarity with strangers, disregarding
social conventions for acceptable behavior.
35. Mood and affect:
Anxiety and fear: initial
Labile mood
Anger and hostility
Aggression
Wandering at night
Agitation
withdrawal
Thought processes and Content:
Initial: abstract thinking is impaired
Delusions of persecution
36. Sensorium and Intellectual process
Memory deficits
Confabulation: make up answers to fill up
gaps
Agnosia
Confusion
Hallucination
Judgement and insight
Poor judgment
Insight is limited
37. Self- concept
Angry and frustrated: initially
sadness
Roles and relationships
Work performance suffers
Roles deteriorate
Limits in relationship
Psychologic and self-care considerations
Disturbed sleep-wake cycles
Incontinence
Neglect bathing and grooming
38. Data Analysis
Risk for injury
Disturbed sleep pattern
Risk for deficient fluid volume
Risk for imbalance nutrition: less than body
requirements
Chronic confusion
Impaired environmental interpretation syndrome
Impaired memory
Impaired social interaction
Impaired verbal communication
Impaired role performance
39. Nursing Interventions
Promoting patient’s safety and
protecting from injury.
Offer unobtrusive assistance with or
supervision of cooking, bathing, or
self-care activities.
Identify environmental triggers to
help client avoid them.
40. Promoting adequate sleep, proper nutrition
and hygiene and activity.
Prepare desirable foods and foods client can
self- feed; sit with client while eating.
Monitor bowel elimination patterns; interfere
with fluids and fiber or prompts.
Remind client to urinate; provide pads or
diapers as needed, checking and changing
them frequently to avoid infection, skin
irritation, unpleasant odors.
Encourage mild activity such as walking.
41. Providing emotional support.
Be kind, respectful, calm and
reassuring; pay attention to client.
Structuring environment and routine.
Encourage clients to follow regular
routine and habits of bathing and
dressing rather than imposing on new
ones.
Monitor amount of environmental
stimulation, and adjust when needed.
42. Promoting interaction and
involvement
Plan activities geared towards client’s
interests and activities
Reminisce with client about the past
If client is nonverbal, remain alert to
nonverbal behavior.
Employ techniques of distraction, time
away, going along, or reframing to calm
clients who are agitated, suspicious, or
confused.