ALZHEIMER’S DISEASE Signs and Symptoms:

 Memory Impairment
Definition:  Agnosia
 Is a neurodegenerative disorder marked by cognitive and  Difficulty Concentrating
behavior impairment that significantly interferes with social  Problem finishing daily tasks
and occupational. Common cause of dementia.  Dementia
 Amnesia
Anatomy and Physiology:
Complications:

 Depression

 Wandering

 Malnutrition and Dehydration

 Falls

 Restlessness

Brain
 In Alzheimer’s Disease, plaques develop in the
hippocampus, a structure deep in the brain that helps
encode memories, and in other areas of the cerebral cortex
that are involved in thinking and making decisions.
Formation of neurofibrillary tangles may result in
communication between neurons and later in the death of
the cells.

Predisposing Factors:

Modifiable Factors: Non-Modifiable Factors

1. Plaques in the Hippocampus 1. Age: 60-65 years old
2. Diabetes Mellitus 2. Gender: More common in
3. High Blood pressure male
PATHOPHYSIOLOGY: DIAGNOSTIC PROCEDURE

Brain Mental Status Examination

 Is the psychological equivalent of a physical exam that
describes the mental state and behaviors of the person
Neurofibrilliary tangels and filaments wrapped in the neurons of being seen. It includes both objective observations of the
cerebral cortex clinician and subjective descriptions given by the patient.

Normal Findings:
Decreased acetylcholinesterase and choline acethyltransferase  Mental status reveal that the patient is able to respond
properly on the test and has a good grade in the examination
such speech, affect, cognitive, behavior, appearance and
Hippocampus atrophy and cerebral atrophy mood.
Significance:
 The MSE provides information for diagnosis and assessment
Memory impairment and decreased intellectual functioning of disorder and response to treatment.

NURSING DIAGNOSIS:
Cognitive impairment and impaired motor function
1. Disturbed sensory perception related to changes in
perception
Dementia 2. Self-care deficit related to neuromuscular impairment
3. Disturbed personal identity related to organic brain
disease
Alzheimer’s Disease
#1. Disturbed sensory perception related to changes in
perception

Desired outcome:
 Regain or maintain usual level of cognition.
 Recognize and correct or compensate for sensory
impairments.

Nursing Interventions Rationale

1. Identify client with condition
that can affect sensing,
interpreting and communicating
stimuli.
2. Review results of sensory and
Specific clinical concerns of the
present condition.
To note presence or possible
motor neurological testing and
laboratory studies.
3. Interpret stimuli and offer
feedback
4. Monitor drug regimen
5. Collaborate with other health
team members in providing
rehabilitative therapies.
#2. Self-care deficit related to neuromuscular impairment
Desired Outcome:
 Demonstrate techniques and lifestyle changes to meet self-
care needs
 Perform self-care activities within level of own ability.
Nursing Interventions
1. Perform or assist client with
meeting client’s needs
2. Develop plan of care
appropriate to individual situation
and desired goals and decision
making.
3. Active client’s concerns
4. Assist with medication
regimen
5. Collaborate with rehabilitation
professionals
cause of changes in response to
sensory stimuli
To assist client to separate from
fantasy or altered perception
To identify prescription with side
effects that may cause
perceptual problems
To achieve maximal gains in
function and psychosocial well-
being.
Rationale
To provide proper care to the
patient
Enhances commitment to plan,
optimizing outcomes and
supporting recovery
Exhibits regard for clients values
and beliefs
To provide treatment regimen
To assess environmental and
discharge care needs.
#3. Disturbed personal identity related to organic brain disease
Desired Outcomes
 Verbalize acceptance of changes that have occurred
 Integrate threat in a healthy, positive manner
Nursing Interventions Rationale
1. Provide calm environment Help client remain calm and
able to discuss important issues
2. Allow client to deal with May be unable to cope with
situation in small steps larger picture when stress is
overload
3. Maintain reality orientation with Client may become defensive,
confronting client’s irrational blocking opportunity to look at
beliefs other possibilities
4. Provide accurate information Helps client make positive
about threat. decisions for future.
5. Refer to appropriate support Enhances facilitation of care for
groups the patient
NURSING INTERVENTIONS:
1. Assist patient’s ability for thought processing every shift
2. Assess the level of cognitive disorders such as change to
orientation to people, places and time, range, attention.
3. Assess level of confusion and disorientation
4. Assess patient’s ability to cope with events
5. Orients patient to environment as needed.
 baseline behavior is observed.
DRUG STUDY
 Caution patient and caregiver that
Generic Name CHLORPROMAZINE donepezil/memantine may cause
Trade Name THORAZINE drowsiness and dizziness.
Drug Classification ANTIPSYCHOTIC
Side Effects  -Blurred Vision Caution patient to avoid activities
 -Neuroceptic Malignant requiring alertness.
 -Hypotension
 -Constipation
Nursing Responsibility  -Assess mental status
 -Monitor BP and Pulse
rate
 -The drug may be taken
with or without food
 -Monitor for
development of
neuroleptic malignant

 Generic Name  DONEPEZIL HYDROCHLORIDE

 Trade Name  ARICEPT
 Drug  CHOLINESTERASE INHIBITOR
Classification
 Side Effects  nausea, vomiting, diarrhea;
 loss of appetite;
 muscle pain;
 sleep problems (insomnia); or.
 feeling tired;.

 Nursing  Do not take more than prescribed

Responsibility Missed doses should be skipped
and regular schedule returned to
the following day; higher doses do
not increase effects but may
increase side effects.
 Inform patient/family that it may
take wk before improvement in