A 68-year-old patient who is hospitalized with pneumonia is disoriented and confused 3 days after admission. Which information indicates that the patient is experiencing delirium rather than dementia?
The patient was oriented and alert when admitted.
Which intervention will the nurse include in the plan of care for a patient with moderate dementia who had an appendectomy 2 days ago?
Remind the patient frequently about being in the hospital.
When administering a mental status examination to a patient with delirium, the nurse should
choose a place without distracting stimuli.
The nurse is concerned about a postoperative patients risk for injury during an episode of delirium. The most appropriate action by the nurse is to
assign unlicensed assistive personnel (UAP) to stay with the patient and offer reorientation.
A 56-year-old patient in the outpatient clinic is diagnosed with mild cognitive impairment (MCI).Which action will the nurse include in the plan of care?
Schedule the patient for more frequent appointments.
The nurse is administering a mental status examination to a 48-year-old patient who has hypertension. The nurse suspects depression when the patient responds to the nurses questions with
I dont know.
A 68-year-old patient is diagnosed with moderate dementia after multiple strokes. During assessment of the patient, the nurse would expect to find
loss of recent and long-term memory.
Which action will help the nurse determine whether a new patients confusion is caused by dementia or delirium?
Use the Confusion Assessment Method tool.
A 72-year-old female patient is brought to the clinic by the patients spouse, who reports that she is unable to solve common problems around the house. To obtain information about the patients current mental status, which question should the nurse ask the
What did you eat for breakfast?
A patient is being evaluated for Alzheimers disease (AD). The nurse explains to the patients adult children that
a diagnosis of AD is made only after other causes of dementia are ruled out.
Which nursing action will be most effective in ensuring daily medication compliance for a patient with mild dementia?
Having the patients family member administer the medication
A patient who has severe Alzheimers disease (AD) is being admitted to the hospital for surgery. Which intervention will the nurse include in the plan of care?
Maintain a consistent daily routine for the patients care.
A 71-year-old patient with Alzheimers disease (AD) who is being admitted to a long-term care facility has had several episodes of wandering away from home. Which action will the nurse include in the plan of care?
Place the patient in a room close to the nurses station.
The day shift nurse at the long-term care facility learns that a patient with dementia experienced sundowning late in the afternoon on the previous two days. Which action should the nurse take?
Keep blinds open during the daytime hours.
The nurses initial action for a patient with moderate dementia who develops increased restlessness and agitation should be to
assess for factors that might be causing discomfort.
When administering the Mini-Cog exam to a patient with possible Alzheimers disease, which action will the nurse take?
Ask the person to use a clock drawing to indicate a specific time.
Which hospitalized patient will the nurse assign to the room closest to the nurses station?
Patient with new-onset confusion, restlessness, and irritability after surgery
After change-of-shift report on the Alzheimers disease/dementia unit, which patient will the nurse assess first?
Patient who developed a new cough after eating breakfast
After reviewing the health record shown in the accompanying figure for a patient who has multiple risk factors for Alzheimers disease, which topic will be most important for the nurse to discuss with the patient?
Tobacco use
The spouse of a 67-year-old male patient with early stage Alzheimers disease (AD) tells the nurse, I am exhausted from worrying all the time. I dont know what to do. Which actions are best for the nurse to take next (select all that apply)?
Offer ideas for ways to distract or redirect the patient.
Teach the spouse about adult day care as a possible respite.
Ask the spouse what she knows and has considered about dementia care options.
Which nursing actions could the nurse delegate to a licensed practical/vocational nurse (LPN/LVN) who is part of the team caring for a patient with Alzheimers disease (select all that apply)?
Administer the prescribed memantine (Namenda).
Remove potential safety hazards from the patients environment.