A nurse is caring for a client who is taking lithium and reports experiencing lethargy, muscle weakness, and blurred vision. Which of the following responses should the nurse make?

Choice A reason: An altered level of consciousness is not typically associated with Alzheimer's disease. Patients with Alzheimer's may experience confusion or disorientation, but changes in consciousness, such as stupor or coma, are not characteristic symptoms of the disease.

Choice B reason: Failure to recognize familiar objects, known as agnosia, is a common finding in Alzheimer's disease. As the disease progresses, the ability to recognize objects, faces, and even sounds can be impaired, which is a direct result of the deterioration of brain areas involved in processing sensory information.

Choice C reason: Excessive motor activity is not a common finding in Alzheimer's disease. While patients may experience restlessness, the disease often leads to a decrease in overall activity levels due to cognitive decline and the eventual difficulty with coordination and motor functions.

Choice D reason: Rapid mood swings can occur in Alzheimer's disease, but they are not as prominent as other cognitive symptoms. Mood changes in Alzheimer's are usually a result of the frustration and confusion experienced by the patient rather than a direct symptom of the disease itself.

Choice A reason: Assisting the client to use new coping strategies is an important part of managing bipolar disorder, but it is not the first action a nurse should take when establishing a nurse-client relationship. Coping strategies will be more effective once a trusting relationship has been established and the client feels secure in sharing personal information.

Choice B reason: Establishing confidentiality guidelines with the client is the first and most crucial step in forming a therapeutic nurse-client relationship. It sets the foundation for trust and openness, ensuring the client understands that their personal information will be protected and shared only with those directly involved in their care.

Choice C reason: Helping the client to make behavioral changes is a goal in the treatment of bipolar disorder. However, before any interventions can be planned or implemented, the nurse must first establish a rapport and trust with the client, which begins with ensuring confidentiality.

Choice D reason: Sharing information with the client about their disorder is essential for their understanding and participation in care. However, this should occur after establishing a relationship in which the client feels comfortable and secure, knowing their privacy is respected.