A patient with severe dementia no longer recognizes family ...

[piesebel]

A patient with severe dementia no longer recognizes family members and becomes anxious and agitated when they attempt reorientation. Which alternative could the nurse suggest to the family members?
 
  a. Wear large name tags.
  b. Focus interaction on familiar topics.
  c. Frequently repeat the reorientation strategies.
  d. Place large clocks and calendars strategically.

Question 2

Goals of care for an older adult patient diagnosed with delirium caused by fever and dehydration will focus on:
 
  a. returning to premorbid levels of function.
  b. identifying stressors negatively affecting self.
  c. demonstrating motor responses to noxious stimuli.
  d. exerting control over responses to perceptual distortions.

[Tabitha_2016]

Answer to Question 1

ANS: B
Reorientation may seem like arguing to a patient with cognitive deficit and increases the patient's anxiety. Validating, talking with the patient about familiar, meaningful things, and reminiscing give meaning to existence both for the patient and family members. The option that suggests using validating techniques when communicating is the only option that addresses an interactional strategy. Wearing large name tags and placing large clocks and calendars strategically are reorientation strategies. Frequently repeating the reorientation strategies is inadvisable because patients with dementia sometimes become more agitated with reorientation.

Answer to Question 2

ANS: A
The desired overall goal is that the delirious patient will return to the level of functioning held before the development of delirium. Demonstrating motor response to noxious stimuli is an indicator appropriate for a patient whose arousal is compromised. Identifying stressors that negatively affect the self is too nonspecific to be useful for a patient with delirium. Exerting control over responses to perceptual distortions is an unrealistic indicator for a patient with sensorium problems related to delirium.