Psychiatric & Cognitive Disorders

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Psychiatric & Cognitive Disorders
2013-08-07 16:37:41

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  1. Dementia is a disturbance of memory with multiple cog. deficits including (4)
    • 1. aphasia
    • 2. apraxia
    • 3. agnosia
    • 4. executive fun. (plan, organize, sequence)
  2. 7 stages of dementia
    • 1. no disability
    • 2. pt. c/o forgetting normal age-related info (location of objects)
    • 3. Beginning signs & deficits noted
    • 4. Deficits noted in all IADL
    • 5. Person can't fun. independently
    • 6. Ind. can't perform ADLs without cues
    • 7. Vegetative state, bedbound, unable to respond verbally or non-verbally
  3. Stage 3 Dementia 
    Beginning signs & deficits noted

    Strengths: I IADL, avoids challenging situations, utilize compensation as adaptive mechanism

    Weakness: fogets imp. info. for first time in life, diff. completing tasks, diff. negotiating direction to new location
  4. Stage 4. Dementia
    Deficits notes in IADLs

    Strengths: I ADLs, live at home with support, follow simple verbal & demo cues

    Weakness: increasingly forgetful, unable to follow sequence with written cues, unable to perform familiar, challenging act, diff. word finding, cant manage home without ass.
  5. Stage 5 Dementia
    Can't function I

    Strength: can perform ADL, some IADL with cues assistance, responds to encouragement

    Weakness: can't drive, poor judgement, diff. all decision making, forget to care for hygeine
  6. Stage 6 Dementia
    Cant perform ADL without cues

    Strength: perf. components of familiar task, follows demo/hand-over hand cues

    Weakness: sign. deficits in following 2-step task, can't sequence ADL, cant speak full sent., incontinent bowel/bladder
  7. What groups is best for mid-stage dementia
  8. What groups are best for ind. in later stage dementia
    Sensory stimulation act. due to being at risk for sensory deprivation.
  9. T/F assembly of wooden toys is best act. for group for ind. in acute, psychiatric hospital
    T-the act. are structured, completed in one session, & provide concrete result to reinforce reality.  

    Discussions & verbal act. are not recommended for ind. with poor orientation to reality (too abstract & include one to process feelings, adequate verbal skills, & level of insight).
  10. Cutting: 
    a. snip paper, open & close & move in controlled forward motion
    b. Cut simple figures
    c. cut circles
    d. complex shapes
    e. simple geometric shapes
    • a=3
    • b=4-6
    • c=3.5-4.5
    • d. 6-7
    • e. 3-4
  11. For an ind. hospitalized with major life changes & role assumptions & loss, what skill is most relevant for OT to evaluate.
  12. Lithium overdose (mood stabilizer)
    Gross hand tremors, motoric disturbances
  13. Monoamine Oxidase Inhibitors (MAHI's)
    What types of meds (2)
    Nardil & Parnate
  14. Precautions of MAOIs
    • 1. dietary restrictions: no food with amino acid tyramine
    • 2. aged cheese, pickled foods, cured/smoked meats, liver, yogurt, souc cream, overripe fruits, chocolate, beer, wine, soy, 
    • 3. over counter drugs (cold, sinus, fever meds, decongestion, asthma, appetite)
  15. Side-effects of MAOI that require immediate medical attention
    • 1. Hypertensive crisis, increased BP-stroke cardiac reactions
    • 2. severe headache, palpitations
    • 3. stop meds immediately, consult dr.
  16. What is validation therapy and what population is it used with?
    • Dementia
    • Unspoken messages are more important than the actual content of speech.  
    • Focus is to facilitate communication in caring, respectful & empathetic manner.
  17. What approach is being used when an OT listen's to the words an ind. used to ascertain the ind. underlying message
    Used with ind. with dementia
    Validation therapy
  18. T/F Ind. with moderate or trainable mental retardation can complete ADLs, live in a group home setting, and do unskilled work in a sheltered workshop.
  19. T/F A child with profound mental retardation would not require nursing care for basic survival skills if family was seeking community living
    F-would requires this type of care
  20. T/F A child with severe mental retardation requires supervision to accomplish most tasks.
  21. T/F a child who is able to learn academic skills at 3-7th grade level is mildly mentally retarded & educable
  22. T/F Short-term memory loss is typical of ECT (electroconvulsive treatments)
    T-providing effective cues during activities can effectively help ind. deal with this memory loss & allow effective engagement in meaningful act.
  23. Antipsychotic/pschotrophic meds
  24. What type of group
    Utilizes short term activities that require participation of 2 or more people.  Tasks are shared and focus is on interaction rather than task completion. Ind. needs to be socially responsive and have intact cognition.
    Project group.
  25. T/F 6 hours after ECT an ind. is capable of engaging in structured tasks.
    T-may be temporary memory loss, don't give client task where they have to use memory to complete.
  26. dynamic international approach
    awareness questioning to help ind. detect errors, estimate task difficulty, and predict outcomes.
  27. transfer of training approach
    remedial/restorative that focuses on restoration of components to increase skill.  Deficit specific & utilizes tabletop and computer activities as tx modalities
  28. Give an ind. ___________ prompts for ideational apraxia