Term
|
Definition
| dysfunction in any one or several of the areas previously identified that interferes with daily life |
|
|
Term
| causes of cognitive impairment |
|
Definition
| stress, depression, substance use/abuse, physiological causes (50+), delirium, MCI, dementia |
|
|
Term
|
Definition
|
|
Term
| annual conversion rate to dementia |
|
Definition
|
|
Term
|
Definition
| a syndrome of progressively worsening cognitive function, beginning with disorientation and emory loss, through loss of executive functioning, gross personality changes and ending with complete inability to care for self; AD is most common dementia |
|
|
Term
| AD is what percentage of all dementias |
|
Definition
| about 65%; 4.9 million Americans have AD |
|
|
Term
| percentage of vascular dementia |
|
Definition
|
|
Term
| prevalence of dementia in persons >65 in US |
|
Definition
| 6-8%. Increases to almost 50% in persons >85 |
|
|
Term
| why do nurses need to know about CI? |
|
Definition
| patient education, ability of patient to care for him/herself at home, medication management, assist with procedures in the hospital, safety |
|
|
Term
|
Definition
| mini mental state examination, sweet 16, clock drawing test, mini-cog, MOCA |
|
|
Term
|
Definition
| 1. orientation to person, place, time 2. registration (ability to name objects) 3. attention/concentration 4. recall (form of memory) 5. language 6. executive function |
|
|
Term
| Limitations of CI screening |
|
Definition
| does not provide a diagnosis--only probability of CI, affected by culture, affected by education |
|
|
Term
| how many adverse events in hospitals are medication-related? |
|
Definition
| 1 in 3; more than half are preventable |
|
|
Term
| how many older persons experience ADEs |
|
Definition
| 35%; 50% judged preventable |
|
|
Term
| How many >65 taking meds; more than 5 |
|
Definition
| 79%; 39% taking >5 medications |
|
|
Term
| common drug-drug interactions |
|
Definition
| warfarin, digoxin, ACE inhibitors, phenytoin |
|
|
Term
|
Definition
| CV systemic effects, effect digoxin levels, adverse interactions with Warfarin |
|
|
Term
|
Definition
| Potentially Inappropriate Medication |
|
|
Term
| What are risk factors for ADR |
|
Definition
| dementia, multiple cormorbidities, renal insufficiency, recent hospitalization, >85 years, multiple prescribers, regular use of alcohol, prior ADR |
|
|
Term
| risky med classes for ADRs |
|
Definition
| anticholinergics, benzodiapezepiens, antipsychotics, sedatives, NON-ASA, non COX2 NSAIDS, TCAs, opiods, corticosteroids, Warfarin |
|
|
Term
|
Definition
| adverse drug event: injury occurring during drug therapy resulting from appropriate or suboptimal care. Includes adverse drug rx during normal use or as a result of an error |
|
|
Term
|
Definition
| adverse drug reaction: noxious or unintended effect of a drug that occurs at a normal therapeautic dose |
|
|
Term
|
Definition
| Beers criteria for PIM use in older adults; considered best practice for care of older adults, 2 parts |
|
|
Term
|
Definition
| 1. patient education & empowerment 2. comprehensive med history on admission 3. interdisciplinary collaboration: if something doesn't seem right--ASK physician, pharmacist |
|
|
Term
| Interventions: Understand prescribing principles |
|
Definition
| 1. start low and go slow, less is more 2. discontinue unnecesary meds 3. try nonpharm interventions 4. recommend safer drugs 5. optimize drug regimen 6. avoid the prescribing cascade 7. avoid inappropriate meds |
|
|
Term
|
Definition
| 1. consider new sx as possible ADR before giving new med 2. watch out for wrong drug choices (Beers) 3. document therapeutic and AE of meds consistently 4. contribute to a culture of safety that allows for exploration of all ADRs |
|
|
Term
|
Definition
| 1. reconciliation: consider adapting dosing times realistically for persons living at home 2. adherence issues 3. paatient and caregiver education: who will be giving meds? |
|
|
Term
|
Definition
| 1. demerol 2. amitriptyline (Elavil) 3. antipsychotics w/ persons with dementia 4. benzodiazepines |
|
|
Term
|
Definition
| temporary state, cannot maintain attn, can be d/t systemic issue, such as a UTI |
|
|
Term
average ambulatory patient on how many meds?
average institutionalized patient on how many? |
|
Definition
|
|
Term
| how many older adults take OTC meds? |
|
Definition
90%
older adults consume more than 1/3 of all prescription drugs, 40% of all OTC meds |
|
|
Term
what percentage of older adults experience ADEs? how many preventable?
prevalence of ADR-related hospitalizations |
|
Definition
35%, 50% preventable
5-35% |
|
|
