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    CASE Study

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    Mary Shane Aragon Moralde
    The 72-year-old male patient has been experiencing progressive cognitive decline over the past year as reported by his daughter, including problems with memory, orientation, mood, and behavior. An assessment found the patient has signs and symptoms consistent with early-stage dementia, including disorientation, forgetfulness, agitation, and difficulty remembering family members. Based on his medical history of heart disease and presentation, the diagnosis is most likely Alzheimer's disease.

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    CASE Study

    Uploaded by

    Mary Shane Aragon Moralde
    56 views5 pages
    The 72-year-old male patient has been experiencing progressive cognitive decline over the past year as reported by his daughter, including problems with memory, orientation, mood, and behavior. An assessment found the patient has signs and symptoms consistent with early-stage dementia, including disorientation, forgetfulness, agitation, and difficulty remembering family members. Based on his medical history of heart disease and presentation, the diagnosis is most likely Alzheimer's disease.

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    CASE Study

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    The 72-year-old male patient has been experiencing progressive cognitive decline over the past year as reported by his daughter, including problems with memory, orientation, mood, and behavior. An assessment found the patient has signs and symptoms consistent with early-stage dementia, including disorientation, forgetfulness, agitation, and difficulty remembering family members. Based on his medical history of heart disease and presentation, the diagnosis is most likely Alzheimer's disease.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    56 views5 pages

    CASE Study

    Uploaded by

    Mary Shane Aragon Moralde
    The 72-year-old male patient has been experiencing progressive cognitive decline over the past year as reported by his daughter, including problems with memory, orientation, mood, and behavior. An assessment found the patient has signs and symptoms consistent with early-stage dementia, including disorientation, forgetfulness, agitation, and difficulty remembering family members. Based on his medical history of heart disease and presentation, the diagnosis is most likely Alzheimer's disease.

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    © All Rights Reserved
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    of 5

    B.

    MENTAL HEALTH ASSESSMENT FINDINGS

    ASSESSMENT FINDINGS DISCUSSION


    72 years old Aging is one of the risk factors that precipitates
    the development of dementia.
    Male Male sex is linked to a faster rate of cognitive
    deterioration.
    daughter reports that she noticed his father has Because dementia affects the regions of the brain
    progressively had problems with his mental involved in remembering, understanding, and
    capacity. That the changes seems worse over a
    past year processing information, it can damage a person's
    capacity to make decisions.
    Daughter revealed at times his father is alert, Presence of some time of alertness,
    and at other times he seems disoriented, disorientation, depression and forgetfulness is on
    depressed,He is forgetting things and doing the early stage of dementia.
    things out of the ordinary
    He could not pour his own coffee, and he seems Agitation is a behavioral syndrome characterized
    to be getting more agitated.at times, has by increased, restlessness, aggressiveness, and
    difficulty remembering the names of family
    members and friends emotional distress that is usually present to the
    patients with dementia.
    Neighbor found him down the street 2 days ago, Gradual loss of memory is one of the cardinal
    and patient  K.B. did not know where he was.  symptom of dementia.
    past medical history is significant for Coronary artery disease, which is linked to brain
    hypercholesterolemia and coronary artery small vessel disease, may lead to dementia.
    disease.
    myocardial infarction 5 years ago In some studies, Myocardial Infarction was linked
    to an increased risk of vascular dementia, and
    this link was stronger in individuals who had a
    stroke.
    Vital signs today are all within normal limits.K.B. Vital signs and well-being of the patient is within
    is discharged and sees his primary care normal limits and it is a good sign.
    physician 2 days later

    C. Psychosocial Stage

    Psychosocial Stage: Integrity vs Despair Age: 65 years old and older

    Case Study 2 (copy)

    In relation to the case presented, the patient has a positive resolution with the Psychosocial Stage for
    the reason that he had regretted nothing. He had nurtured a daughter who had helped him during this
    time and he has a neighbor who have eyes on him in times that he is out of their household. Apart from
    the presence of his mental illness there is none negative resolution in terms of the psychosocial stage.

    Source: https://www.verywellmind.com/integrity-versus-despair-2795738
    D. DIAGNOSIS

    Diagnosis: Alzheimer’s Disease

    Dementia's pathophysiology isn't totally known. The accumulation of native proteins in the brain causes
    most kinds of dementia, with the exception of vascular dementia.

    Alzheimer's disease is characterized by extensive cortical atrophy and the formation of amyloid plaques
    and tangles of hyperphosphorylated tau protein in neurons, all of which contribute to the destruction of
    the neurons. The intracellular deposition of Lewy bodies (insoluble aggregates of alpha-synuclein) in
    neurons, primarily in the cortex, is a hallmark of Lewy body dementia. Deposition of ubiquitinated TDP-
    43 and hyperphosphorylated tau proteins in the frontal and temporal lobes causes dementia, early
    personality and behavioral abnormalities, and aphasia in frontotemporal dementia. Vascular dementia is
    caused by ischemic brain injury (such as a stroke), which results in persistent neuronal loss.

    Source: https://www.ncbi.nlm.nih.gov/books/NBK557444/#article-20337.s5
    Medication Indication Mechanism of Action Contraindication Adverse Effects Nursing Responsibilities
    Generic Name: treatment of The commonly accepted Hypersensitivity to Body as a  Monitor patient for therapeutic
    dementia of the cholinergic hypothesis proposes donepezil or tracine, Whole: Headache, fatigue.  effectiveness: Improvement as noted on
    Donepezil Alzheimer's type, that a portion of the cognitive GI bleeding, and the Alzheimer's Disease Assessment
    Off-label uses and behavioral decline jaundice. CNS: Insomnia, dizziness, Scale.
    include the associated with Alzheimer's are depression, tremor, irritability,  Monitor patient closely for S&S of GI
    Brand Name: management of the result of decreased vertigo, ataxia.  ulceration and bleeding
    vascular dementia, cholinergic transmission in the
    Parkinson's central nervous system.  Monitor cardiovascular status; drug may have
    CV: Syncope, hypertension, vagotonic effect on the heart, causing
    Aricept Disease-associated Donepezil selectively and
    atrial fibrillation, hot flashes, bradycardia
    dementia, and Lewy reversibly inhibits the
    hypotension.   Educate patient with Exercise caution.
    body dementia acetylcholinesterase enzyme,
    Dosage: which normally breaks down Fainting episodes related to slowing the
    acetylcholine. The main GI: Nausea, diarrhea,
    heart rate may occur.
    pharmacological actions of this vomiting, muscle cramps,
    5mg PO/ day at night
    drug are believed to occur as anorexia, GI bleeding,
    the result of this enzyme bloating, fecal incontinence,
    inhibition, enhancing cholinergic epigastric pain. 
    transmission, which relieves the
    symptoms of Alzheimer's Respiratory: Dyspnea. 
    dementia. In addition to the
    above, other mechanisms of Skin: Pruritus, sweating,
    action of donepezil are possible, urticaria.
    including the opposition of
    glutamate-induced excitatory
    transmission via downregulation
    of NMDA receptors and the
    regulation of amyloid proteins,
    which have demonstrated
    significant effects on the disease
    process of Alzheimer's.
    Source: https://go.drugbank.com/drugs/DB00843
    Problem Rationale

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