COGNITIVE DISORDERS

DELIRIUM & DEMENTIA

 PREPARATION
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KARAR AMER RAHMAN GHAYDAA BASSIM MOSA FATIMA MUSA HASSAN FATIMA FARED FADL
Student Student Student Student

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 LEARNING OBJECTIVES
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• DISTINGUISH BETWEEN DELIRIUM AND DEMENTIA IN

T E R M S O F S Y M P TO M S , C O U R S E ,T R E AT M E N T, A N D

P RO G N O S I S

• A P P LY T H E N U R S I N G P RO C E S S TO T H E C A R E O F C L I E N T S

WITH COGNITIVE DISORDERS.

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 LEARNING OBJECTIVES
COGNITIVE DISORDERS

• P ROV I D E E DU C ATI O N TO C L I E N TS, FA MI L I E S,

C A R E G I V E R S, A N D C O MMU N I T ME MB E R S TO
I N C R E A SE KN OW L E DG E A N D U N D E R STA N D I N G O F
C O G N I TI V E DI SO R DE R S.

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 INTRODUCTION
Cognition is the brain’s ability to process,
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retain, and use information. Cognitive abilities

include reasoning, judgment, perception,
attention, comprehension, and memory.
These cognitive abilities are essential for
Many important tasks, including making
decisions, solving problems, interpreting the
environment, and learning new information

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 COGNITIVE DISORDER
A cognitive disorder is a disruption or
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impairment in these higher level

functions of the brain. Cognitive
disorders can have devastating effects
on the ability to function in daily life.
They can cause people to forget the
names of immediate family members,
be unable to perform daily household
tasks, and neglect personal hygiene.

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 DELIRIUM
Delirium is a syndrome that involves a disturbance of
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consciousness accompanied by a change in cognition.

Delirium usually develops over a short period, sometimes
a matter of hours, and fluctuates, or changes, throughout
the course of the day. Clients with delirium have difficulty
paying attention, are easily distracted and disoriented, and
may have sensory disturbances such as illusions,
misinterpretations, or hallucinations.
 DELIRIUM
An electrical cord on the floor may appear to them as a
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snake (illusion). They may mistake the banging of a

laundry cart in the hallway for a gunshot
(misinterpretation). They may see “angels” hovering above
when nothing is there (hallucination). At times, they also
experience disturbances in the sleep–wake cycle, changes
in psychomotor activity, and emotional problems such as
anxiety, fear, irritability, euphoria, or apathy.
 ILLUSION HALLUCINATIO
N
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 ETIOLOGY

DELIRIUM ALMOST ALWAYS RESULTS

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F ROM AN ID EN TIF IABLE

PHY SIOLOGICAL, METABOLIC , OR
CEREBRAL D ISTURBAN CE OR D ISEASE OR
F ROM D RUG IN TOXICATION OR
WITHD RAWAL.

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 MOST COMMON CAUSES OF DELIRIUM

1 . PHYSIOLOGICAL OR METABOLIC
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2 . IN F ECTION

3 . DRUG RELATED

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 BOX MOST COMMON CAUSES
PHYSIOLOGICAL
INFECTION DRUG RELATED
OR METABOLIC

Hypoxemia; electrolyte Systemic: Sepsis, urinary tract Intoxication: Anticholinergics,

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disturbances; renal or hepatic infection, pneumonia lithium, alcohol, sedatives, and

failure; hypoglycemia or hypnotics
hyperglycemia; dehydration; sleep Cerebral: Meningitis,
deprivation; thyroid or encephalitis, HIV, syphilis Withdrawal: Alcohol,
glucocorticoid disturbances; sedatives, and hypnotics
thiamine or vitamin B12
Reactions to anesthesia,
deficiency; vitamin C, niacin, or
protein deficiency; cardiovascular prescription medication, or
shock; brain tumor; head injury; illicit (street) drugs
and exposure to gasoline, paint
solvents, insecticides, and related
substances

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 TREATMENT AND PROGNOSIS
The primary treatment for delirium is to identify and treat
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any causal or contributing medical conditions. Delirium is

almost always a transient condition that clears with successful
treatment of the underlying cause. Nevertheless, some causes
such as head injury or encephalitis may leave clients with
cognitive, behavioral, or emotional impairments even after the
underlying cause resolves. People who have had delirium are
at higher risk for future episodes.

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 PSYCHOPHARMACOLOGY
Clients with quiet, hypoactive delirium need no specific
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pharmacologic treatment aside from that indicated for the

causative condition
1. An antipsychotic medication, such as haloperidol
(Haldol), may be used in doses of 0.5 to 1 mg to
decrease agitation and psychotic symptoms, as well
as to facilitate sleep.

2. Short- or intermediate-acting benzodiazepines, such

14 as lorazepam (Ativan), have been used.
 OTHER MEDICAL TREATMENT

1. Adequate nutritious food and fluid intake

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speed recovery.
2. IV fluids or even total parenteral nutrition
may be necessary if a client’s physical
condition has deteriorated and he or she
cannot eat and drink
3. Physical restraints may be necessary so that
needed medical treatments can continue.
Restraints are used only when necessary

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 DEMENTIA
Dementia is a mental disorder that
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involves multiple cognitive deficits,

primarily memory impairment, and at
least one of the following cognitive
disturbances:

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 STAGES OF DEMENTIA
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• M I L D D E M E N T I A : T H E C L I E N T H A S D I F F I C U LT Y F I N D I N G W O R D S ,

F REQ U ENT LY LO SES O BJ ECT S , AND BEGI NS TO EXP ERI ENCE

ANXI ET Y ABO U T T HES E LO SSES .

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 STAGES OF DEMENTIA
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• M O D E R AT E D E M E N T I A : C O N F U S I O N W I T H P RO G R E S S I V E

M E M O RY L O S S . ( T H E P E R S O N N O L O N G E R C A N P E R F O R M

C O M P L E X TA S K S B U T R E M A I N S O R I E N T E D T O P E R S O N A N D

P L AC E ) .

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 STAGES OF DEMENTIA
COGNITIVE DISORDERS

• S E VERE D E MENTIA: PERSONALIT Y AND EMOT IONAL CHANGES

O C C U R . T H E P E R S O N M AY B E D E L U S I O N A L , W A N D E R AT N I G H T,

F O RG E T T H E N A M E S O F H I S O R H E R S P O U S E A N D C H I L D R E N , A N D

R E Q U I R E A S S I S TA N C E I N AC T I V I T I E S O F D A I L Y L I V I N G .

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 ETIOLOGY
C A U S E S V A RY, T H O U G H T H E C L I N I C A L P I C T U R E I S S I M I L A R F O R M O S T
DEMENTIAS.
1. Alzheimer disease
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2. Lewy body dementia,

3. Vascular dementia
4. Frontotemporal lobar degeneration (originally called Pick disease)
5. Prion diseases
6. HIV infection
7. Parkinson disease
8. Huntington disease
21 9. Traumatic brain injury
 TREATMENT AND PROGNOSIS
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 POINTS TO CONSIDER WHEN
WORKING WITH
CLIENTS WITH DEMENTIA
1 . R E M E M B E R H O W I M P O RTA N T I T I S TO P RO V I D E D I G N I T Y
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F O R T H E C L I E N T A N D FA M I LY A S T H E C L I E N T ’ S L I F E
ENDS.
2 . R E M E M B E R T H AT D E AT H I S T H E L A S T S TA G E O F L I F E . T H E
N U R S E C A N P RO V I D E E M O T I O N A L S U P P O RT F O R T H E
C L I E N T A N D FA M I LY D U R I N G T H I S P E R I O D .
3 . C L I E N T S M AY N O T N O T I C E T H E C A R I N G , PAT I E N C E , A N D
S U P P O RT T H E N U R S E O F F E R S , B U T T H E S E Q U A L I T I E S
W I L L M E A N A G R E AT D E A L TO T H E FA M I LY F O R A LO N G
TIME.
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 C O M PA R IS O N O F D E L IR IU M A N D D E M E N TIA

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 REFERENCE
• Sheila L. Videbeck Psychiatric- Mental
Health Nursing Eighth Edition ©2020
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p (1063-1015)

• Margaret Jordan Halter, VARCAROLIS ’

Foundations of Psychiatric Mental Health
Nursing SEVENTH EDITION
© 2014p (451- 431)

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