The PMHNP is seeing a 70-year-old for impairment of mental f…
The PMHNP is seeing a 70-year-old for impairment of mental function and concerns that depression could be playing a role. After doing a thorough assessment, the NP notes the patient also has had a slowly progressive gait disorder, and urinary incontinence. About 1 year ago, she started having weakness and tiredness in her legs, followed by unsteadiness; her steps became shorter and shorter, and she also experienced unexplained backward falls. She is becoming emotionally indifferent, inattentive, and her actions and thinking have become “dull.” Over the past month, she started having urinary urgency and involuntary leaking of urine. Besides multivitamins and local application of Timolol for glaucoma, she takes no other medications; there are no other symptoms. Suddenly the NP recalls the phrase “wet, wacky, and wobbly” in her mind and calls a colleague in neurology knowing the patient might need a for the symptoms. The PMHNP thinks about other things that can cause dementia-like symptoms. Even though she believes she has diagnosed it correctly, providers should never forget other common causes of dementia including: which is caused by cerebrovascular disease or impaired cerebral blood flow OR which is caused by extracellular amyloid beta deposition and neurofibrillary tangles.