Alzheimer's disease is a progressive, nonreversible form of dementia that causes memory loss and impairments in other cognitive abilities such as language, motor skills, and abstract thinking. Risk factors include advanced age, genetics, head injuries, and female sex. Symptoms include memory loss, personality changes, impaired judgment, and difficulties in social situations. Diagnosis involves ruling out other conditions through tests like MRI, CT scans, and EEG, though a definitive diagnosis can only be made through brain tissue examination after death. Available medications can temporarily slow progression but do not cure the disease. Nursing care focuses on safety, communication, routine, stimulation, and monitoring for skin breakdown or other issues.

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

10. 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

11. 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.

12. 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:

13. 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.

14. Hemiplegia/paraplegia

15. Gullian – barre syndrome (polyneuritis)