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: This response may seem dismissive and could minimize the client's feelings. It's important to acknowledge the client's emotions as valid and unique to their experience, rather than comparing them to others.

Choice B reason: This response invites the client to share their feelings in a non-judgmental space and shows the nurse's willingness to listen. It respects the client's autonomy and provides an opportunity for them to open up about their concerns at their own pace.

Choice C reason: While this response is meant to be reassuring, it may inadvertently invalidate the client's feelings. Embarrassment is a personal emotion, and what might seem trivial to one person can be significant to another.

Choice D reason: This response implies that sharing will lead to relief, which may not always be the case. It also puts pressure on the client to disclose information before they are ready, which could be counterproductive.

Choice A reason: Initiating hospice care services is generally considered when the client is in the final stages of Alzheimer's disease and has a life expectancy of 6 months or less. Hospice care focuses on comfort and quality of life, rather than curative treatments. It's an option when the disease has significantly progressed, not typically at the time of initial diagnosis.

Choice B reason: Transcranial magnetic stimulation (TMS) is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain and is being studied as a potential treatment for improving cognitive status in Alzheimer's patients. However, it is not yet a standard treatment and is considered experimental.

Choice C reason: Barbiturate medications are not typically used to control anxiety in Alzheimer's patients due to the risk of dependency and the potential to worsen cognitive impairment. Other medications, such as selective serotonin reuptake inhibitors (SSRIs), are generally preferred for managing anxiety in these patients⁷.

Choice D reason: NMDA receptor antagonists, such as memantine, are medications that can help delay cognitive symptoms in patients with moderate to severe Alzheimer's disease. They work by regulating the activity of glutamate, a neurotransmitter involved in learning and memory, which may be overactive in Alzheimer's disease.