Which intervention would best address the nursing diagnosis of ...

[PhilipSeeMore]

Which intervention would best address the nursing diagnosis of Imbalanced nutrition for elderly patients in stages 2 to 3 of Alzheimer's disease?
 
  a. Monitor the frequency and characteristics of bowel movements.
  b. Offer finger foods the patient can take away from the table.
  c. Monitor intake and output, and take patient weights each week.
  d. Provide protein-dense foods to provide for neurological regrowth.

Question 2

Documentation in a patient's record shows: During 5-minute interaction, patient fidgeted, tapped foot, periodically covered face with hands, looked under chair. Stated, I enjoy spending time with you. Which assessment is most accurate?
 
  a. The patient gave positive feedback about the nurse's communication techniques.
  b. The nurse is viewing the patient's behavior through a cultural filter.
  c. The patient's verbal and nonverbal messages were incongruent.
  d. Psychotic thought processes are likely.

[meganmoser117]

Answer to Question 1

B
Persons in stages 2 and 3 of Alzheimer's are prone to distractibility and wandering, so providing finger foods that they can eat away from the table is likely to increase the amount of nutrients they consume. Bowel movements are not a reliable indicator of nutritional status. Elderly people with Alzheimer's may forget to eat and often have very erratic intakes, putting them at risk for dehydration, which is best monitored via daily weights, since hydration can change so quickly in an elderly, confused person. Nutrient-dense foods would be desirable, but protein-dense foods would not present a balanced diet; furthermore, treatments at this time do not result in neuroregeneration.

Answer to Question 2

C
When a verbal message is not reinforced with nonverbal behavior, the message is confusing and incongruent. Some clinicians call it a mixed message. Positive feedback is not evident. A cultural filter determines what we will pay attention to and what we will ignore, which is not relevant to the situation presented. Data are insufficient to draw the conclusion that the patient is psychotic.

[PhilipSeeMore]

Gracias!

[epscape]

TYSM