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(Answered) NR507 Week 7: Discussion Case Scenario A 76-year -old man is brought to the primary care office by his wife with concerns about his worsening memory.$8.49
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(Answered) NR507 Week 7: Discussion Case Scenario A 76-year -old man is brought to the primary care office by his wife with concerns about his worsening memory.
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Course
NR507 WEEK 7 (NR507)
Institution
Chamberlain College Of Nursing
(Answered) NR507 Week 7: Discussion
Case Scenario
A 76-year -old man is brought to the primary care office by his wife with concerns about his worsening memory. He is a retired lawyer who has recently been getting lost in the neighborhood where he has lived for 35 years. He was recently found wan...
case scenario a 76 year old man is brought to the primary care office by his wife with concerns about his worsening memory he is a retired lawyer who has recently been
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Chamberlain College Of Nursing
NR507 WEEK 7 (NR507)
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(Answered) NR507 Week 7: Discussion
Case Scenario
A 76-year -old man is brought to the primary care office by his wife with concerns
about his worsening memory. He is a retired lawyer who has recently been
getting lost in the neighborhood where he has lived for 35 years. He was recently
found wandering and has often been brought home by neighbors. When asked
about this, he becomes angry and defensive and states that he was just trying to
go to the store and get some bread.
His wife expressed concerns about his ability to make decisions as she came
home two days ago to find that he allowed an unknown individual into the home
to convince him to buy a home security system which they already have. He has
also had trouble dressing himself and balancing his checkbook. At this point, she
is considering hiring a day-time caregiver help him with dressing, meals and
general supervision why she is at work.
Past Medical History: Gastroesophageal reflux (treated with diet); is negative
for hypertension, hyperlipidemia, stroke or head injury or depression
Allergies: No known allergies
Medications: None
Family History
o Father deceased at age 78 of decline related to Alzheimer’s disease
o Mother deceased at age 80 of natural causes
o No siblings
Social History
o Denies smoking
o Denies alcohol or recreational drug use
o Retired lawyer
o Hobby: Golf at least twice a week
Review of Systems
o Constitutional: Denies fatigue or insomnia
o HEENT: Denies nasal congestion, rhinorrhea or sore throat.
o Chest: Denies dyspnea or coughing
o Heart: Denies chest pain, chest pressure or palpitations.
o Lymph: Denies lymph node swelling.
o Musculoskeletal: denies falls or loss of balance; denies joint point or
swelling
General Physical Exam
o Constitutional: Alert, angry but cooperative
o Vital Signs: BP-128/72, T-98.6 F, P-76, RR-20
o Wt. 178 lbs., Ht. 6’0″, BMI 24.1
HEENT
, o Head normocephalic; Pupils equal and reactive to light bilaterally; EOM’s
intact
Neck/Lymph Nodes
o No abnormalities noted
Lungs
o Bilateral breath sounds clear throughout lung fields.
Heart
o S1 and S2 regular rate and rhythm, no rubs or murmurs.
Integumentary System
o Warm, dry and intact. Nail beds pink without clubbing.
Neurological
o Deep tendon reflexes (DTRs): 2/2; muscle tone and strength 5/5; no gait
abnormalities; sensation intact bilaterally; no aphasia
Diagnostics
o Mini-Mental State Examination (MMSE): Baseline score 12 out of 30
(moderate dementia)
o MRI: hippocampal atrophy
o Based on the clinical presentation and diagnostic findings, the patient is
diagnosed with Alzheimer’s type dementia.
Discussion Questions
1. Compare and contrast the pathophysiology between Alzheimer’s disease
and frontotemporal dementia.
2. Identify the clinical findings from the case that supports a diagnosis of
Alzheimer’s disease.
3. Explain one hypothesis that explains the development of Alzheimer’s
disease
4. Discuss the patient’s likely stage of Alzheimer’s disease.
1. Compare and contrast the pathophysiology between Alzheimer's
disease and frontotemporal dementia.
Alzheimer’s disease is the leading cause of severe cognitive
dysfunction in older adults, (McCance, K.L. & Huether, S.E., 2019). It is a
progressive disease that starts off with mild memory loss and possibly
leading to loss of the ability to carry on a conversation and respond to the
environment. At first, Alzheimer’s disease typically destroys neurons and
their connections in parts of the brain involved in memory, including the
entorhinal cortex and hippocampus. It later affects areas in the cerebral
cortex responsible for language, reasoning, and social behavior. It is
believed that Alzheimer’s disease has two pathologic hallmarks:
extracellular beta-amyloid deposits, and intracellular neurofibrillary tangles,
(Ricciarelli, R., & Fedele, E., 2017). The buildup of beta-amyloid deposition
and neurofibrillary tangles leads to the loss of synapses and neurons. The
abnormal levels of beta-amyloid protein clumps together to form plaques
that collect between neurons and disrupt cell function. Neurofibrillary
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