When caring for an older adult client who is experiencing memory ...

[jman1234]

When caring for an older adult client who is experiencing memory loss, the nurse notes that the client emotionally overreacts to situations, appearing as if having temper tantrums when responding to real or perceived frustration
 
  . The nurse recognizes the client is experiencing a catastrophic reaction. When caring for this client, the nurse should
 
  a. attempt to keep the client awake for extended periods of time.
  b. demand the client stop demonstrating inappropriate behavior.
  c. increase the client's environmental stimuli.
  d. use distraction to move the client away from the offending environmental stimuli.

Question 2

The nurse is performing an admission assessment on a client with cognitive impairment. When developing a plan of care for this client, the nurse should plan to
 
  a. provide instructions one step at a time.
  b. offer several instructions at a time when orienting the client to their room.
  c. teach the client new skills using complex instructions with multiple steps.
  d. refrain from mentioning the client's past life experiences when asking questions.

[31809pancho]

Answer to Question 1

ANS: D
Instead of focusing on the behavior, the nurse should try to identify and eliminate the cause(s). The nurse should use distraction to move older adults away from the offending stimuli in the environment or use postponement. Older adults with memory loss lack the cognitive ability to develop alternatives. They emotionally overreact to situations and can have what look like temper tantrums in response to real or perceived frustration. Older adult tantrums are called catastrophic reactions and represent a completely disorganized set of responses. Usually there is something in the immediate environment that precipitates the reaction. Fatigue, multiple demands, overstimulation, misinterpretations, or an inability to meet expectations are contributing factors.

Answer to Question 2

ANS: A
Cognitively impaired clients have trouble following instructions consisting of multiple steps. Breaking instructions into single steps helps these clients master tasks that otherwise are beyond their comprehension. Keep the conversation simple and focused on one step at a time. Asking mild to early moderate cognitively impaired older adults about their past life experiences is a way to connect verbally with those who might have difficulty telling you what they had for breakfast 2 hours ago. Remote memory (recall of past events) is retained longer than memory for recent events. When cognitively impaired adults share memories, they are giving a gift to the nurse by sharing part of themselves when they may have very little else to give.

[jman1234]

TYSM

[FergA]

Excellent