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 D
Explanation
A: Using an overhead loudspeaker can be disorienting or frightening for clients with dementia.
B: A written schedule may not be helpful if the client has difficulty reading or understanding due to cognitive decline.
C: While allowing choices is good, it can be overwhelming for someone with dementia depending on their cognitive ability.
D: A consistent routine helps provide structure and predictability, which can reduce confusion and anxiety in clients with dementia.
Correct Answer is A
Explanation
A: Sundown syndrome involves increased confusion and agitation during the late afternoon or evening in individuals with dementia.
B: Dementia is a broader condition that sundown syndrome falls under but does not specifically describe the evening confusion.
C: Age-associated memory impairment refers to normal changes in memory due to aging and does not include confusion and agitation.
D: Delirium is typically acute and can be caused by various factors, not specifically tied to time of day like sundown syndrome.
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