Alzheimer’s Disease

Submitted by:
Janine M. Mandap

Submitted to:
Criscencia Tenoso
 Introduction and Disease Process

Alzheimer is the 6th leading cause in the United States. It kills more than breast
cancer and prostate cancer. Every 66 seconds someone in the United States develops
the disease. 1 in 3 seniors dies with Alzheimer or another dementia.

Prevalence

The number of Americans living with Alzheimer's disease is growing — and growing fast.
An estimated 5.5 million Americans of all ages have Alzheimer's disease.

Of the estimated 5.5 million Americans living with Alzheimer's dementia in 2017, an
estimated 5.3 million are age 65 and older and approximately 200,000 individuals are
under age 65 and have younger-onset Alzheimer's.

 One in 10 people age 65 and older (10 percent) has Alzheimer's dementia.
 Almost two-thirds of Americans with Alzheimer's are women.
 African-Americans are about twice as likely to have Alzheimer's or other dementias as
older whites.
 Hispanics are about one and one-half times as likely to have Alzheimer's or other
dementias as older whites.

Because of the increasing number of people age 65 and older in the United States,
particularly the oldest-old, the number of new cases of Alzheimer's and other dementias
is projected to soar. Today, someone in the United States develops Alzheimer's
dementia every 66 seconds. By mid-century, someone in the United States will develop
the disease every 33 seconds.

Mortality

Alzheimer's disease is the sixth-leading cause of death in the United States. It is the
fifth-leading cause of death among those age 65 and older and a leading cause of disability
and poor health.

As the population of the United States ages, Alzheimer's is becoming a more

common cause of death. It is the only top 10 cause of death that cannot be prevented,
cured or even slowed.

Although deaths from other major causes have decreased significantly, official
records indicate that deaths from Alzheimer's disease have increased significantly. Between
2000 and 2014, deaths from Alzheimer's disease as recorded on death certificates increased
89 percent, while deaths from the number one cause of death (heart disease) decreased 14
percent.

Among people age 70, 61 percent of those with Alzheimer's are expected to die
before the age of 80 compared with 30 percent of people without Alzheimer's — a rate
twice as high.

Trend

In the history of medicine, one means to progress is when we make the decision that
our assumptions and definitions of disease are no longer consistent with the scientific evidence,
and no longer serve our health care needs. The arc of scientific progress is now requiring a
change in how we diagnose Alzheimer's disease. Both the National Institute on Aging –
Alzheimer's Association (NIA-AA) 2011 workgroup and the International Work Group (IWG)
have proposed guidelines that use detectable measures of biological changes in the brain,
commonly known as biological markers, or biomarkers, as part of the diagnosis.

The development and validation of Alzheimer's disease biomarkers — including those

detectable in the blood or cerebral spinal fluid, or through neuroimaging — is a top research
priority. It has the potential to markedly change how we diagnose Alzheimer's disease and, as a
result, how we count the number of people with this disease.

As research advances a biomarker-based method for diagnosis and treatment at the

earliest stages of Alzheimer's disease, we envision a future in which Alzheimer's disease is
placed in the same category as other chronic diseases, such as cardiovascular disease or
diabetes, which can be readily identified with biomarkers and treated before irrevocable
disability occurs.
 Patient’s Profile

Name: Maria Cristina Ladia

Age: 81 years old

Sex: Female

Civil Status: Widow

Nationality: Filipino

Religion: Roman Catholic

Birthday: December 15, 1935

Birthplace: Manila

Most recent profession: Business woman

Highest education attainment: College

Address: Mandaluyong, City

History of Present Illness

Patient was diagnosed Alzheimer five years ago. She was admitted or placed here in
Camillus Medhaven accompanied by her relatives. Since 2011, the patient was complaining
memory lapses and aside from that she has problems with higher cognitive function, there have
been changes with her behavior and activities of daily living. She has an uncontrolled
hypertension for the past 10 years. Her highest recorded blood pressure is 150/110 mm Hg and
her usual blood pressure is 130/100 mm Hg. She only took hypertensive medicine once to lower
her blood pressure. She drinks alcohol occasionally. She is a non-smoker.

Past Medical History

The patient acknowledges chicken pox and measles during his childhood days. However,
she had not experience having mumps, rubella, rubeola, scarlet fever, nor rheumatic fever. She
had completed his immunizations and tetanus shot but no follow up boosters during his high
school days. The patient has no known allergy to food, animals, insects and drugs.
 Family of the Client
The patient has four siblings and three children. The patient had no history of heart,
kidney and liver problem. Her father had a history of hypertension and died from lung cancer at
the age of 37 years of age. Her mother had a history of respiratory problem. Her father died at
the age of 37 years old due to lung cancer while her mother died at the age of 75 years old.
Both her parents were drinking alcohol in moderation either occasionally or when they have no
work. The patient has no neurologic history in her family.

Father Mother

Died: 37 years old Died: 75 years old

History: Hypertension, Lung History: Asthma

Cancer

Cielito Cristina Sonny Luicida

Poen
Aban Aban Aban Aban
Aban

Marion Ladia Jun Ladia

Emma King
55 yrs. Old 49 yrs. Old
53 yrs. old.
Single Married
Married
Medical consultant Engineer
Lawyer
 Laboratory and
Diagnostic Exams
 URINALYSIS

Name: LADIA, MA. CHRISTINA Room: Sex: Female Change slip no: L1709111318

Address: MANDALUYONG CITY Age: 80 Transaction No.: 2301

Physician: BOSETA, MARTHA Date: 09/29/2017

PHYSICAL EXAMINATION MICROSCOPIC EXAMINATION

Color: YELLOW Pus Cells: 0-2/HPF

Transparency: SLIGHT TURBID RBC: 0-1/HPF

Specific Gravity: 1.010 Epithelial Cells: FEW

Mucus Threads:
CHEMICAL EXAMINATION

Albumin: NEGATIVE

Sugar: NEGATIVE

pH: 7.0

Name: LADIA, MA. CHRISTINA Age: 80 Room: OPD Transaction Date: 09/29/2017
Physician: BOSETA, MARTHA Sex: Female Change Slip No.: L170911270

EXAMINATIONS RESULTS NORMAL EXAMINATIONS RESULTS NORMAL

RANGE RANGE
FBS 3.96 3.90-5.80 Blood Urea 6.74 2.50-7.50
mmol/L Nitrogen mmol/L
DGCT/RBS/2PPBS 4.40-7.20 Sodium 135-145
mmol/L mmHg
Creatinine 80-115 Potassium 3.50-5.30
Male umol/L mmol/L
Female 80.9
Blood Uric Acid 53-97 Chloride 96-107
Male umol/L mmol/L
Female 0.23
Total Cholesterol 4.41 0.21-0.45 Calcium 2.15-2.56
mmol/L mmol/L
Triglycerides 1.07 0.15-0.40 Phosphorous 0.87-1.45
mmol/L mmol/L
HDL 2.41 0.91-1.56 Magnesium 0.70-0.98
mmol/L mmol/L
LDL 1.50 <4.20 Total Protein 66-80 g/L
mmol/L
Bilirubin Total 0-17.1 Albumin 35-50 g/L
Direct 0-5.10 Globulin 25-35 g/L
mmol/L
Indirect 0-12.0 AIG Ratio 1.5-2.5
mmol/L
Alkaline 35- 130 U/L HbA1C 5.4% 4.00-8.00%
Phosphatase
Serum Amylase 0-90 IU/L LDH 132-228 U/L
Lipase 10-150 IU/L CPK Total
Male 36-174 U/L
Female 28-140 U/L
SGOT 23.8 0-40 U/L CPK-MB 0-25 U/L
SGPT 11.9 0-41 U/L HGT 70-120
mg/dL
DRUG STUDY
 Generic Classification Mechanism of Indications Contraindications Side effects & Adverse Nursing Responsibilities
Name/Brand Action effects
name
Generic Antiplatelet To interfere To reduce Allergy to salicylates Side effects: Acid or  Observe 12 Rights
Name: with clotting recurrent or NSAIDs sour stomach, anxiety,  Perform physical
Aspirin by keeping a transient Allergy to tartrazine belching, dizziness, dry assessment (skin color,
platelet- ischemic (cross-sensitivity to mouth, hyperventilation, reflexes,etc.)
Brand Name: aggregating attacks and aspirin is common) irritability, shaking,  Institute emergency
Bayer substance from stroke Hemophilia stomach discomfort, procedures if overdose
forming. Bleeding ulcers upset, or pain, trouble occurs
Dosage: Hemorrhagic states sleeping,  Give drug with food or
80 mg/tablet Blood coagulation unusual drowsiness, after meals if GI upset
defects dullness, tiredness, occurs
Frequency: Hypoprothrombinem weakness, or feeling of  Use the drug only as
Once a day ia sluggishness suggested; avoid
after lunch Vitamin K Adverse effects: overdose
deficiency Acute aspirin toxicity  Avoid the use of over
Route: Oral Aspirin intolerance the counter drugs while
Rash, hives, urticarial taking this drug
Nausea, dyspepsia,
heartburn, epigastric
discomfort, anorexia,
hepatotoxicity
Occult blood loss,
hemostatic defects,
bleeding, anemia
Hypersensitivity
Dizziness, tinnitus,
difficulty hearing,
nausea, vomiting
diarrhea, mental
confusion, lassitude
 Generic Classification Mechanism of Indications Contraindications Side effects & Adverse Nursing Responsibilities
Name/Brand Action effects
name
Generic Side effects:
Name:
Norvasc

Brand Name:

Dosage:

Frequency: Adverse effects:

Route: Oral
NURSING CARE PLAN
 ASSESSMENT NURSING SCIENTIFIC PLANNING INTERVENTION RATIONALE EVALUATION
DIAGNOSIS ANALYSIS
Subjective:

Objectives:

(Nurse’s
Pocket Guide-
Diagnoses,
Prioritized
Interventions,
and Rationales
by Marilynn E.
Doenges, Mary
Frances
Moorhouse,
Alice C. Murr
p.