1.
Alzheimer’s Disease
Alzheimer’s disease (AD) is a nonreversible type of dementia
that progressively develops over many years.
Dementia is defined as multiple cognitive deficits that impair
memory and can affect language, motor skills, and/or abstract
thinking.

2.
Risk Factors
Advanced age
Genetic predisposition
Environmental agents (herpes virus, metal, or toxic waste)
Previous head injury
Sex (female)

3.
Clinical manifestation
AD is characterized by
 Memory Loss,
 Problems With Judgment
 Changes In Personality
Forgetfulness
Difficulty in social or work situations
Loss of awareness of recent events and surroundings
movement is lost › Unrecognizable speech(at sever stage)

4.
Tests
 Genetic testing for the presence of apolipoprotein E can determine if late-
onset dementia is due to AD.
 There is no definitive diagnostic procedure, except brain tissue examination
upon death.
 Magnetic resonance imaging (MRI), computed tomography (CT) and
electroencephalogram (EEG) may be performed to rule out other possible
causes of findings

5.
Medications
 Most medications for clients who have dementia attempt to target behavioral
and emotional problems, such as anxiety and depression.
 These medications include antipsychotics, antidepressants, and anxiolytics.
Clients receiving these medications should be closely monitored for adverse
effects.
 AD medications temporarily slow the course of the disease and do not work
for all clients.
 If a client fails to improve with one medication, a trial of one of the other
medications is warranted.

6.
Nursing Care
 Assess cognitive status, memory, judgment, and personality changes.
 Provide a safe environment.
 Keep the client on a sleeping schedule and monitor for irregular sleeping
patterns.
 Provide verbal and nonverbal ways to communicate with the client.
 Offer snacks or finger foods if the client is unable to sit for long periods of
time.
 Check the client’s skin weekly for breakdown.

7.
Cont.…
 Offer varied environmental stimulations, such as walks, music, or craft
activities.
 Keep a structured environment and introduce change gradually (client’s
daily routine or a room change).
 Use a calendar to assist with orientation.
 Use short directions when explaining an activity or care the client
needs, such as a bath.

8.
Cerebral Aneurysm
A cerebral aneurysm is a balloon-like out-pouching caused by a
congenital or developed weakness in a cerebral artery.
 Trauma, infection, or vessel wall lesions due to atherosclerosis
can all lead to the development of an aneurysm.
Increased pressure within the vessel lumen may cause the
aneurysm to rupture, causing significant intracranial bleeding

9.
SIGNS AND SYMPTOMS
Asymptomatic until rupture
Very bad headache due to hemorrhage and increased intracranial
pressure
Decreased level of consciousness due to increased intracranial
pressure from blood accumulating within the brain

10.
INTERPRETING TEST RESULTS
 Angiogram highlights the aneurysm due to structural abnormality.
 CT scan shows the aneurysm unless it is very small.
 Digital subtraction angiography shows the detail of the vasculature—
abnormal structure.
 Diffusion/perfusion MRI or MRA (magnetic resonance angiography)
shows vessel structure.

11.
Medical TREATMENT
Surgical repair of the aneurysm.
Administer corticosteroid drugs to reduce inflammation:
Administer anticonvulsant drugs to reduce seizure risk due
to irritation of brain:

12.
NURSING INTERVENTION
 Monitor the patient’s neurological function for changes—typically
use Glasgow Coma Scale or similar tool to grade response to
stimuli/
 Monitor vital signs for changes—widened pulse pressure with
bradycardia indicative of increased intracranial pressure.
 Explain to the patient:
Needs for homecare.
When to call healthcare provider.

13.
Hemiplegia/paraplegia

14.
Gullian – barre syndrome (polyneuritis)