A nurse in an assisted-living facility is caring for a client who is in early stages of dementia. The client has been oriented to name and place and is usually cooperative. Which of the following nursing actions is appropriate if the client refuses to take morning medications?
Notify the charge nurse of the need for evaluation of the client's level of competence.
Ask the client to express her reasons for refusing the morning medications and document the event.
Crush the pills, if not contraindicated, and hide them the client's in applesauce.
Try to talk the client into adherence by telling her the possible implications of missing a dose.
The Correct Answer is B
A: While assessing competence might eventually be necessary, it should come after understanding the client's reasons for refusal.
B: This action respects the client’s autonomy and provides insights into her thinking or possible misconceptions that can be addressed.
C: Crushing pills without consent and hiding them in food is unethical and could be dangerous, as some medications are not meant to be crushed.
D: Trying to convince the client might be seen as coercive. Understanding her reasons first is a more patient-centered approach.
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Related Questions
Correct Answer is A
Explanation
A: Goals must be relevant and important to the client to encourage engagement and commitment to the therapeutic process.
B: While regular evaluations are essential, they must align with the individual’s progress and specific needs rather than a set schedule.
C: Goals should indeed be achievable, but tying them strictly to discharge may not accommodate ongoing or long-term needs.
D: While physician input can be valuable, goals should be client-centered and driven by nursing assessments and the therapeutic plan.
Correct Answer is D
Explanation
A: Frontal dementia (or frontotemporal dementia) is characterized by changes in personality and behavior, not directly linked to cardiovascular disease.
B: Lewy body dementia involves protein deposits in nerve cells and is known for its distinctive sleep disturbances and hallucinations.
C: Alzheimer’s is the most common form of dementia but is typically associated with age-related neurodegenerative changes rather than directly with cardiovascular disease.
D: Vascular dementia is directly associated with conditions that block or reduce blood flow to the brain, often due to cardiovascular disease.
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