An older client admitted to the hospital after having sustained a ...

[maegan_martin]

An older client admitted to the hospital after having sustained a fall at home is diagnosed with a right hip fracture and experienced a surgical reduction of the fracture.
 
  At 2:30 AM, she awakens from sleep insisting that her daughter is in the other room and wants to see her. Attempts to reorient her to the surroundings are unsuccessful. In reviewing the client's record, what data would be considered a primary risk factor for the delirium?
  a. History of dementia
  b. Death of the client's husband last month
  c. The client's age
  d. History of cardiac disease

Question 2

An older client diagnosed with dementia resides with his daughter. When the homecare nurse visits, the daughter tearfully tells the nurse that her father scratched her hand and cursed at her when she was attempting to feed him.
 
  She states, I don't know why he hates me and wants to hurt me. I try so hard to take good care of him. I love him. How will the nurse respond to the client's daughter?
  a. Let's think about what you may have done to anger your father?
  b. Let's try to figure out what your father was trying to say with his behavior.
  c. Scratching is usually a sign of untreated pain. Do you think your father is in pain?
  d. Maybe you should consider having a home health care provider take over re-sponsibility for your father's physical care.

[debra928]

Answer to Question 1

ANS: A
Older people who have undergone surgery and those with dementia are particularly vulnerable to delirium. While the other options may be factors, they are not as influential as the correct option.

Answer to Question 2

ANS: B
Dementia often interferes with the person's communication and the ability to understand and express thoughts and feelings. The focus needs to be on what the person is attempting to com-municate through behavior. Behavioral manifestations are not necessarily signs of anger in per-sons with dementia. Although behavioral manifestations frequently are seen in persons with un-treated pain, this is not always true. The issue here is not necessarily the individual who is providing the care but perhaps the care activity itself. It is appropriate for the daughter to provide care for her father.

[maegan_martin]

TYSM

[amandalm]

Excellent