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Author Question: The nurse is interviewing a 50-year-old with a suspected cognitive disorder. The client has a long ... (Read 80 times)

lidoalex

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The nurse is interviewing a 50-year-old with a suspected cognitive disorder. The client has a long history of alcoholism.
 
  When the nurse asks if he is employed, the client replies that he is currently employed as a conductor on a national railway system. The client's wife takes the nurse aside and informs her that the client has not worked for several years and never worked for the railway. The nurse attributes the client's answer to which of the following explanations?
  A) The client is ashamed that he is unemployed and trying to cover for it.
  B) The client may be manipulating the nurse.
  C) The client may be going through alcohol withdrawal.
  D) The client may have Wernicke-Korsakoff syndrome.

Question 2

The wife of a client with dementia tells the nurse that her husband has been agitated lately. She states, I don't know how to handle this. He was always such a gentle person Which of the following interventions should the nurse suggest?
 
  A) Give the client a sedative when he begins to get agitated.
  B) Distract the client by turning on the television or watching a video.
  C) Distract the client with family photographs and discuss the events pictured.
  D) Leave the client in a safe place in the house and go to another area until he calms down.



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ladyjames123

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Answer to Question 1

Ans: D
Feedback:
Wernicke-Korsakoff syndrome usually is found in the 40- to 70-year-old client with alcoholism and a history of steady and progressive alcohol intake. In time, this person develops a vitamin B1 (thiamin) deficiency that directly interferes with the production of the brain's main nutrient, glucose, resulting in the symptomatology of this syndrome (Sadock and Sadock, 2003). A client with this disorder has great difficulty with recent memory, specifically the ability to learn new information. Because of the inability to recall recent events, the individual fills in memory gaps with fabricated or imagined data (confabulation).

Answer to Question 2

Ans: C
Feedback:
At times, there may seem to be no way to resolve the emotional frustration, agitation, or outbursts of the client who is angry with the environment and those in it. The caregiver might find it beneficial to redirect or distract the client. This can be done by asking to see a client's personal items, such as photographs, and then talking about the family members and life events illustrated by the photographs in the book. This is preferable to pharmacologic interventions. It may be unsafe to leave the client alone when agitated, and television could exacerbate agitation by overstimulating the client.





 

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