Author Question: A patient with vascular dementia wanders from his home. His wife is unable to obtain adequate sleep ... (Read 91 times)

pane00 · **on:** Jul 19, 2018

A patient with vascular dementia wanders from his home. His wife is unable to obtain adequate sleep because most of his wandering efforts occur during the night. Which intervention(s) would be appropriate for this problem? Select all that apply.

a. Enroll the patient in a Safe Return program.
b. Place locks and alarms at the tops of all exits.
c. Arrange for a sitter to watch the patient at night.
d. Request an order for a long-acting benzodiazepine qhs.
e. Use signs to show where desired items are located.
f. Promote high levels of activity during the day.

Question 2

A depressed patient is unable to maintain eye contact with the nurse. The patient's chin drops, and the patient looks at the floor. Which aspect of communication has the nurse assessed?

a. Nonverbal communication
b. A message filter
c. A cultural barrier
d. Social skills

Ahernandez18 · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

A, B, E, F
Interventions that reduce patient wandering, restrict wandering to safe environments, and preserve the patient's safety if he does wander are desirable. These include enrolling the patient in programs that use police and other resources to watch for wandering patients and enable them to return the patient to his home; placing locks and alarms at the top of exit doors (where the patient will be less likely to notice them and defeat them); using signage to help the patient located desired rooms and objects so he does not wander looking for them; and promoting high levels of daytime activity to tire the patient and promote sleep during the night. A sitter is not likely to be a practical solution to a chronic problem because of the expense and access issues. Long-acting benzodiazepines are not a good choice for sedation in cognitive impairment because they increase the risk of delirium and may act cumulatively to increase fall risk, worsen confusion, and/or produce excess sedation or daytime sedation.

Answer to Question 2

A
Eye contact and body movements are considered nonverbal communication. There are insufficient data to determine whether a cultural barrier exists or the level of the patient's social skills.