Author Question: The day shift nurse at the long-term care facility learns that a patient with dementia experienced ... (Read 57 times)

nevelica · **on:** Jun 25, 2018

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?

a. Keep blinds open during the daytime hours.
b. Provide hourly orientation to time and place.
c. Have the patient take a brief mid-morning nap.
d. Move the patient to a quieter room late in the afternoon.

Question 2

A 71-year-old patient with Alzheimer's 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?

a. Reorient the patient several times daily.
b. Have the family bring in familiar items.
c. Place the patient in a room close to the nurses' station.
d. Ask the patient why the wandering episodes have occurred.

leeeep · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: A
A likely cause of sundowning is a disruption in circadian rhythms and keeping the patient active and in daylight will help reestablish a more normal circadian pattern. Moving the patient to a different room might increase confusion. Taking a nap will interfere with nighttime sleep. Hourly orientation will not be helpful in a patient with dementia.

Answer to Question 2

ANS: C
Patients at risk for problems with safety require close supervision. Placing the patient near the nurse's station will allow nursing staff to observe the patient more closely. The use of why questions can be frustrating for patients with AD because they are unable to understand clearly or verbalize the reason for wandering behaviors. Because of the patient's short-term memory loss, reorientation will not help prevent wandering behavior. Because the patient had wandering behavior at home, familiar objects will not prevent wandering.