Mental Health Cognitive Disorders

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Cognitive Disorders
Definitions
Cognition: The act, process, or result of knowing, learning, or understanding -represents a fundamental human feature that distinguishes living from existing -has a distinctive personalized impact on the individual’s physical, psychological, social & spiritual conduct of life -Direct relationship with ADL’s

Cognitive Disorders: Psychiatric disorders that are manifested in deficits in memory, perception, & problem solving.
1) Delirium2) Dementia3) Amnestic Disorder
Delirium
DMS Criteria
A) Disturbance of consciousness reduced clarity of awareness of environment w/ reducded ability to focus, sustain, or shift attention B) A change in cognition (memory deficit, disorientation, language disturbance) or the development of a perceptual disturbance that is not better accounted for by a preexisting, established, or evolving dementia. C) The disturbance develops over a short period of time (hours-days) and tends to fluctuate during the course of the day

Caused by: 1) a general medical condition2) substance-induced 3) Both 1&3 or unknown reasons Delirium: Characterized by a disturbance of consciousness & change in cognition that develop over a short period of time. Always secondary to another problem *considered a priority problem to prevent irreversible damage *two common causes are UTI’s & Benadryl

-can get aggressive or combative
-most frequently seen in older pt.’s
Risk Factors for development
-existing cognitive impairment, low functional autonomy, polypharmacy (especially benzo’s, narcotic analgesics, & anticholinergics), clinical severity of the primary illness Assessment
4 cardinal features:
1) Acute onset & fluctuating course sundowning
2) Inattention need to repeat questions, conversation is difficult, easily distracted by irrelevant stimuli
3) Disorganized thinking
4) Disturbance of consciousness
-pt. may appear withdrawn, agitated of psychotic
-Sundowning is common...
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