The home care nurse is visiting a patient who was discharged to ...

[vicky]

The home care nurse is visiting a patient who was discharged to home after a procedure at an ambulatory surgical center.
 
  The patient lives alone in a senior retirement community. The nurse's assessment docu-ments mild dysphasia. The patient repeatedly asks, Why is there a bandage on my arm? and is not able to state the appropriate day and year. Appropriate planning for the patient should include:
  a. Assessing diet and meal preparation, assessing environment for safety problems, referral to a dementia program
  b. Attending English class to improve speech, transferring finances to a conservator, employing an aide to help with medications
  c. Arranging Meals on Wheels, attending speech therapy, relocation to a skilled nursing facility if no improvement in 1 month
  d. Arranging an appointment at a geriatric assessment program, OT referral for swallowing therapy, teaching to manage public transportation

Question 2

Which of the following should the nurse use as a basis for explaining the etiology of Alzheimer's disease to the family of a patient with this disease?
 
  a. It is a secondary dementia indicated by loss of recent memory and disorientation to time and place.
  b. It is a primary dementia that is incurable, irreversible, and fatal. It is caused by the presence of a beta-amyloid protein in the neurons resulting in senile plaques.
  c. It is a secondary dementia that is treatable with analysis of the diet and removal of toxic substances from the diet and environment.
  d. It is a primary dementia characterized by stepwise decreases in cognitive abilities. It is irreversible but treatable with antihypertensive medications.

[smrtceo]

Answer to Question 1

ANS: A
Further assessment is appropriate before making changes in the living environment. Enrolling in a dementia program will provide stimulation and help the patient maintain intellectual skills. English classes will not improve speech. The other plans might have relevance, howev-er. The remaining sets of options are either irrelevant or beyond the patient's abilities.

Answer to Question 2

ANS: B
This option provides accurate information about Alzheimer's disease. Alzheimer's disease is not a secondary dementia nor is it treated with antihypertensive medications.

[vicky]

TY

[smrtceo]

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