Alzheimer's disease and nursing management

Nursing

1. Alzheimer’s Disease
zainabAkram
BS.Nursing

2. Objectives
Introduction
Origin of Alzheimer’s disease
Meaning
Incidence
Pathophysiology
Risk factors
Signs and symptoms
5 A’s of Alzheimer’s disease

3. Cont
Diagnostic test
Complications
Prevention’s
Treatment
Medical management
Nursing management

4. Introduction
Alzheimer’s disease is a neurodegenerative Brain disorder.
It is the most common form of dementia.
It usually starts in late middle age or in old age (above 65 years)
It is characterized by progressive memory loss.
Formation of neurofibrillary tangles and plaque containing beta –amyloid
cells.

5. Origin of Alzheimer’s Disease
The disease was first described by Dr. AloisAlzheimer a German physician,
in 1906. Alzheimer had ha patient named AugusteD , in her fifties who
suffered from what seemed to be a mental illness. But when she died in
1906, an autopsy revealed dense deposits,nowcalled neuriticplaques,
outside and around the nerve cells in her brain. Inside the cells were
twisted strands of fiber, or neurofibrillary tangles. Since Dr.AloisAlzheimer’s
was the first person who discovered the disease. AD was first named after
him.

6. Meaning
Alzheimer’s disease is chronic, irreversible Disease that
affects the cells of the Brain and causes impairment of
intellectual functioning.
Alzheimer’s disease is a brain disorder which gradually
destroys the ability to reason , remember, imagine and
learn.

7. Incidence
About 3 percent of men and women ages 65 to 74 have Alzheimer’s
disease,andnearly half of those age 85 and older may have the disease.
About 3,60,000 new cases of Alzheimer are diagnosed each year. Almost
two –third of Americans with Alzheimer’s are women.

8. 5 A,s of Alzheimer’s disease
Anomia: can’t remember
names/things
Aproxia: Misuse of object due to
failed recognition
Agnosia: can’t recognize familiar
objects/tastes , Sound.
Amnesia: Memory loss
Aphasia: Can’t express themselves
Via speech.

9. Pathophysiology
Changes in the brain structure and function.
Amyloid palque
Neurofibrillary tangles
Loss of connection between neurons
Neurons death
Plaque develop first in areas of the brain used for memory and cognitive
function including hippocampus, especially the areas responsible for
language and reasoning.
Neurofibrillary tangle

10. Conti…
Abnormal collection of twisted protein threads inside cells.

11. Risk factors
Old age
Female gender
Family history
Genetic mutation
Low socio-economic status
Obesity
Smoking and drinking
Sedentary lifestyle
Head injury

12. Conti…
Diabetes
Hypertension
Hypercholesterolemia
Depression
Down syndrome
Metalaindustrial or other toxins
The abnormal build-up of proteins in and around the Brain
Infection

13. Signs
Memory loss
Difficulty to performing familiar tasks
Problem with language
Disorientation to time and place
Pooreordecreased judgement
Problem with abstract thinking
Misplacing things
Changes in moodeorbehavior

14. Conti…
Changes in personality
Loss of initiative

15. Symptoms of AD
Confusion with time or place
Unexplained mood swings
Problem with attention and spatial orientation
Disturbance in short –term memory
Forgetfulness
Behavior changes
Difficulty swallowing
Unfounded emotions
Trouble with familiar task

16. Preventions of AD
Prevent and manage high BP
Manage blood sugar
Maintain a healthy weight
Be physically active Quit smoking
Avoid excessive drinking
Prevent and correct hearing loss
Get enough sleep
Health diet

17. Conti…
Social engagement
Proper medication
Regular exercise
Logic games
Reading of books
Mental stimulation
Regular sleep
Physical work

18. Conti…
Playing musical instruments
Avoid injuries

19. Medical Diagnosis
No single clinical test but a comprehensive
Evaluate may be done
Physical examination
Psychiatric assessment
Complete health history
Neurological and mental status assessment
Brain imaging test (e.gCT,MRI and SPECT)
CSF examination

20. Conti..
Electromyogram
Electro-encephalogram (EEG)

21. Pharmacological management
Setraline
Haloperidol
Olanzapine
Zolpidem
Antipsychotics
Citalopram
Risperidone

22. Nursing interventions
Avoid harmful substances
Exercise regularly
Excessive drinking drug abuse can damage Brain cell
Use a rather low voice and spoke slowly in front of patient
Assist with ADLs as needed
Provide emotional support to the patient and his family
Establish an effective communication system with the patient and his family to
help them adjust to the patient altered cognitive abilities
Administer ordered medications and notes their affects if the patient has
trouble swallowing, crush tablets and open capsules mix them with a semi soft
food

23. Conti…
Protect the patient from injury by providing a safe ,structured environment
Provide rest periods between activities because the patient tires easily.
Encourage the patient to exercise as ordered to help maintain mobility.
Encourage sufficient fluid intake and adequate nutrition.
Take the patient to the bathroom at least every 2 hours and make sure he
knows the location of bathroom.
Assist the patient with hygiene dressing as necessary.
Frequently check the patient vital signs

24. Conti…
Monitor the patient fluid and food intake to detect imbalances
Inspect the patient skin for evidence of trauma, such as bruises or skin
breakdown
Encourage the family to allow the patient much independence as
possible while ensuring safety to the party and other.


26. Complications
Bedsores
Pneumonia
Dehydration and malnutrition
Wandering and restlessness sleep disturbances
Loss of control of bodily functions
Injuries due to falls
Agitation
Infection

28. Action of mechanism

29. Image