AGOTILLA, Samantha Marie Y.

3NU01

Neuro Case Activity

1. Explain the course of EOAD in the patient's case.

The case revolves around a 68-year-old Caucasian guy who is a retired teacher with a college-level educational background. The
patient, who was 55 years old, was exhibiting signs of cognitive decline, including short-term memory problems and slower, hesitant
speaking. At the age of 57, he was unable to recall the route to his place of employment, demonstrating spatial disorientation. Expert is
confused as to what precipitates the onset of Alzheimer's disease. They believe that two proteins are responsible for the damage and
death of nerve cells. Plaques are formed as a result of the accumulation of fragments of one protein, beta-amyloid. Tangles are made
up of tau protein strands that have twisted together. Plaques and tangles form on the teeth of almost everyone as they become older.
Those suffering from Alzheimer's disease, on the other hand, develop many, many more. In the beginning, these plaques and tangles
cause harm to the brain's memory centers. They begin to influence more sections of the brain as time progresses. Experts are baffled as
to why some people get such a high number of plaques and tangles, or how they spread and cause damage to the brain. In a PET-CT
scan, hypometabolism and atrophy were found in the left temporal lobe as well as the posterior region of the parietal lobes,
respectively.

2. Explain the types of aphasia and how they occur in a patient.

Aphasia is a condition that robs you of the ability to communicate. It can affect your ability to speak, write and understand language,
both verbal and written. It typically occurs suddenly after a stroke or a head injury. But it can also come on gradually from a slow-
growing brain tumor or a disease that causes progressive, permanent damage (degenerative). The severity of aphasia depends on a
number of conditions, including the cause and the extent of the brain damage. Aphasia is categorized as expressive (Broca) or
receptive (Wernicke's). Many patients have a component of both types of aphasia. Degenerative brain disorders cause mainly
Wernicke's aphasia. Primary progressive aphasia (PPA) is the second major form of FTD that affects language skills, such as
speaking, writing and comprehension. Individuals with logopenic variant of PPA, lose the ability to understand or formulate words in
a spoken sentence. In the 45 to 65 age range, both bvFTD and PPA are nearly as common as EOAD.
People with aphasia may have different patterns of strengths and weaknesses:

Expressive aphasia. This is also called Broca's or non-fluent aphasia. People with this pattern of aphasia may understand what other
people say better than they can speak. People with this pattern of aphasia struggle to get words out, speak in very short sentences and
omit words. A person might say, "Want food" or "Walk park today." A listener can usually understand the meaning, but people with
this aphasia pattern are often aware of their difficulty communicating and may get frustrated. They may also have right-sided paralysis
or weakness.

Comprehensive aphasia. People with this pattern of aphasia (also called fluent or Wernicke's aphasia) may speak easily and fluently
in long, complex sentences that don't make sense or include unrecognizable, incorrect or unnecessary words. They usually don't
understand spoken language well and often don't realize that others can't understand them.

Global aphasia. This aphasia pattern is characterized by poor comprehension and difficulty forming words and sentences. Global
aphasia results from extensive damage to the brain's language networks. People with global aphasia have severe disabilities with
expression and comprehension.

Once the cause has been addressed, the main treatment for aphasia is speech and language therapy. The person with aphasia relearns
and practices language skills and learns to use other ways to communicate. Family members often participate in the process, helping
the person communicate.
 3. Formulate one (1) nursing care plan applicable to this patient's case.

Assessment Nursing Planning Intervention Rationale Evaluation

Diagnosis

• Hesitant Impaired verbal STG: Within 8 hours • Assess type and • Helps determine area and Goal met.
speech [and/or written] of proving nursing degree of dysfunction, degree of brain involvement
Communication interventions, the such as receptive and difficulty client has with
• Cognitive may be related client will be able to: aphasia – client does any or all steps of the
decline with to Impaired • Indicate not seem to understand communication process. Client
predominantly cerebral understanding of the words, or expressive may have trouble
short-term circulation; communication aphasia – client has understanding spoken
memory loss neuromuscular problems. trouble speaking or words (damage to Wernicke’s
and slowed impairment making self-understood. speech area), speaking words
LTG: Within 3 days correctly (damage to Broca’s
of providing nursing speech areas), or may
interventions, the experience damage to both
client will be able to: areas.
• Establish method of
communication in • Differentiate aphasia • Choice of interventions
which needs can be from dysarthria. depends on type of
expressed. impairment. Aphasia is a
• Use resources defect in using and interpreting
appropriately. symbols of language and may
involve sensory and/or motor
components, such as inability
to comprehend written or
spoken words or to write, make
signs, and speak. A dysarthric
person can understand, read,
and write language, but has
 difficulty forming or
pronouncing words because of
weakness and paralysis of oral
musculature, resulting in softly
spoken speech.

• Provide alternative • Provides for communication

methods of of needs or desires based on
communication, such as individual situation or
writing or felt board underlying deficit.
and pictures. Provide
visual clues – gestures,
pictures, “needs” list,
and demonstration.

• Anticipate and • Helpful in decreasing

provide for client’s frustration when dependent on
needs. others and unable to
communicate desires.

• Talk directly to client, • Reduces confusion and

speaking slowly and anxiety at having to process
distinctly. Using yes/no and respond to large amount of
questions to start, information at one time. As
progressing in restraining progresses,
complexity as client advancing complexity of
responds. communication stimulates
memory and further enhances
word and idea association.

• Consult with or refer • Assess individual’s verbal

to speech therapist. capacities and sensory, motor,
and cognitive functioning to
identify deficits and therapy
needs.