A nurse is obtaining a preoperative medical and surgical history from a client scheduled for a cataract extraction procedure. Which of the following client statements require further investigation by the nurse?

A. A CT angiogram will reveal any edema within the brain tissue: CT angiography primarily focuses on visualizing blood vessels and blood flow within the brain. While it may incidentally detect areas of edema, its primary purpose is to assess vascular structures rather than brain tissue changes such as edema.

B. A CT angiogram will reveal any overproduction of cerebrospinal fluid (CSF): CT angiography does not assess cerebrospinal fluid (CSF) production. Its main function is to visualize blood vessels and blood flow within the brain, particularly to detect abnormalities such as aneurysms, arteriovenous malformations, or vasospasm.

C. A CT angiogram will reveal any fractures within the skull or spine: CT angiography primarily focuses on imaging blood vessels and is not the preferred modality for detecting fractures within the skull or spine. CT scans or plain radiography are typically used to assess bony structures for fractures.

D. A CT angiogram will reveal any decreased blood flow related to vasospasm: This statement is correct. CT angiography is a specialized imaging technique that combines computed tomography (CT) scanning with contrast dye to visualize blood vessels and blood flow within the brain. It is commonly used to detect and monitor vasospasm, a potentially serious complication of subarachnoid hemorrhage, where blood vessels in the brain constrict, leading to decreased blood flow. CT angiography allows for the visualization of these changes in blood vessel diameter and blood flow dynamics.

A. Weight loss:

Weight loss can occur in individuals with dementia due to various factors, including decreased appetite, difficulty eating or swallowing, and increased energy expenditure.

Monitoring weight regularly can help detect changes in nutritional status and identify potential health concerns, such as malnutrition or dehydration.

B. Decreased mobility:

Individuals with dementia may experience a decline in mobility and functional abilities as the disease progresses.

Monitoring changes in mobility, such as difficulty walking, transferring, or performing activities of daily living, is important for assessing functional decline and implementing appropriate interventions to maintain mobility and prevent complications such as falls.

C. Increased physical activity:

While dementia can lead to decreased physical activity in some individuals, others may exhibit increased restlessness or wandering behaviors.

Monitoring changes in physical activity levels can help identify agitation, restlessness, or wandering behaviors that may require intervention to ensure the safety and well-being of the individual with dementia.

D. Unkempt appearance:

Individuals with dementia may neglect personal hygiene and grooming tasks, leading to an unkempt appearance.

Monitoring changes in appearance, such as poor personal hygiene, disheveled clothing, or neglect of grooming habits, can indicate difficulties with self-care and may necessitate assistance or supervision to maintain hygiene and appearance.

E. Constipation:

Constipation is a common gastrointestinal symptom in individuals with dementia, often due to factors such as reduced fluid intake, decreased physical activity, and side effects of medications.

Monitoring bowel habits and addressing constipation promptly can help prevent discomfort, complications such as fecal impaction, and maintain overall gastrointestinal health in individuals with dementia.