Definition
- Cognitive disorders are characterized by the disruption of thinking, memory, processing, and problem solving.
- Types of cognitive disorders include: delirium, dementia, and memory loss disorders (amnesia or dissociative fugue).
Risk Factors
- Physiological changes such as neurological, metabolic, and cardiovascular disease.
- Cognitive changes
- Family genetics
- Infections
- Tumors
- Sleep disorders
- Substance abuse
- Drug intoxications and withdrawals
Signs and Symptoms
- Irritability; mood most frequently seen in organic brain disorder.
- Change in level of consciousness.
- Difficulty thinking with sudden onset.
- State of awareness ranging from hyper vigilance to stupor or coma.
- Impairment in cognition and thought process, particularly short-term memory.
- Anxiety
- Confabulation
Therapeutic Nursing Management
- The nurse plays a primary role in providing a safe environment for the client and others.
- Exogenous stimuli in the environment can intensify the client’s level of orientation.
- Cognitive changes may often include a period of confusion or forgetfulness.
- The nurse may encourage family members to bring photographs or familiar items as strategy to orient the client.
- Psychological treatment may focus more on the family to offer them support during this stressful time.
- Cognitive changes affect the family and care providers. Cognitive decline often means a change in the family roles and activities of daily living.
- Pharmacologic therapy is implemented to reduce or alleviate the associated symptoms such as antianxiety medications, antidepressants, and antipsychotics.
Nursing Interventions
- Determine the cause and treatment of the underlying causes.
- Remain with the client, monitoring behavior, providing reorientation and assurance.
- Provide a room with a low level of visual and auditory stimuli.
- Provide palliative care with the focus on nutritional support.
- Reinforce orientation to time, place, and person.
- Establish a routine.
- Client protection may be required.
- Have client wear an identification bracelet, in case she or he gets lost.
- The client should not be left alone at home
- Break test into small steps, giving one instruction at a time.
