An older female adult with dementia exhibits new behaviors ...

[eruditmonkey@yahoo.com]

An older female adult with dementia exhibits new behaviors including crying and verba-lizing the same phrase repeatedly; furthermore, the behavior has increased over 2 days.
 
  Which intervention should the nurse implement in response to this behavior? a. Tell her you will remember what she says if she stops crying.
  b. Attribute these findings to deterioration in cognitive function.
  c. Check the medication administration record for missed doses.
  d. Present probing questions to the patient about her behavior.

Question 2

Managed care systems are most effective for an older adult who does which of the following?
 
  a. Avoids using the system until it is really needed in an emergency.
  b. Avoids seeing generalists and seeks health care only from specialists.
  c. Uses high-tech treatments to reduce ex-penses over the long term.
  d. Seeks regular primary care and preventive strategies to maintain health.

[Dunkey]

Answer to Question 1

C

Feedback
A Incorrect. The nurse avoids making a veiled threat to the patient. Giving the pa-tient an incentive to avoid crying can be suitable; however, the incentive should never be attention because the duty the nurse owes to the patient is to pay close attention to her.
B Incorrect. The new behavior can be deteriorating cognitive function, but the nurse must assess the patient further before making that determination.
C Correct. New behaviors with increasing frequency warrant further investigation by the nurse so effective nursing care can be planned and implemented. Crying and repeated verbalizations from a patient with dementia can indicate anxiety, but the cognitive disorder makes anxiety difficult to detect. In addition to checking for missed doses, the nurse checks the medication record for medica-tions that are likely to cause anxiety such as beta-adrenergic agonists used to reverse bronchoconstriction . The nurse should also check for risk factors for an-xiety and perform a comprehensive assessment to identify potential causes.
D Incorrect. One aspect of the assessment is to question the patient. Depending on the stage of dementia, the patient can be an unreliable source of information about herself.

Answer to Question 2

D
Managed care is most effective for individuals who, over a long period of enrollment, use pri-mary care and preventive behavior to avoid the need for intensive treatment.
Avoiding using the system until it is needed in an emergency is both costly and detrimental to the client's health. Managed care systems limit access to specialists and encourage the use of primary care. Managed care systems favor ongoing subacute care and prevention to avoid the need for high-tech, acute treatments.

[eruditmonkey@yahoo.com]

TYSM

[chereeb]

Excellent