A nurse is reviewing the laboratory results for a client who is receiving digoxin and notes a decreased potassium level. The nurse should monitor the client for which of the following adverse effects?

Dementia is a progressive neurocognitive disorder characterized by memory impairment, disorientation, and declining ability to perform activities of daily living. Home care management focuses on promoting safety, reducing confusion, and supporting remaining cognitive function. Clients benefit from structured environments, clear cues, and consistent routines. Nursing education for caregivers emphasizes strategies that enhance orientation and reduce environmental stressors.

Rationale:
A. Giving the client several choices of foods for meals can increase confusion and decision-making difficulty in dementia. Clients with cognitive decline often struggle with processing multiple options, which may lead to frustration or refusal to eat. Simplified choices, such as offering one or two options, are more appropriate.

B. Labeling the door to the bathroom with a symbol provides visual cues that help orient the client and support independence. Dementia impairs memory and spatial recognition, so external memory aids are beneficial. Using clear signage reduces disorientation and promotes safe navigation within the home environment.

C. Avoiding eye contact with the client is inappropriate because it may increase feelings of isolation and anxiety. Maintaining eye contact helps establish trust, improves communication, and provides reassurance. Therapeutic communication is essential in dementia care to support emotional well-being.

D. Increasing environmental stimuli is not recommended for clients with dementia because it can lead to overstimulation and confusion. Excess noise, clutter, or activity may worsen agitation and disorientation. A calm, structured, and predictable environment is more supportive for cognitive stability and safety.

Clients who have experienced a stroke with right-sided hemiplegia have unilateral weakness and impaired motor control on the affected side. Safe transfer techniques are essential to prevent falls, injury, and caregiver strain. Proper positioning of assistive devices and use of the unaffected side improve stability during transfers. Nursing care focuses on promoting safety, maintaining body alignment, and encouraging as much client participation as possible.

Rationale:
A. Asking the client to reach around the nurse’s neck for support is unsafe because it places excessive strain on the nurse and does not provide stable support for the client. This technique increases the risk of injury to both the nurse and the client and does not follow proper transfer mechanics.

B. Placing the wheelchair on the left side of the client is correct because the left side is the unaffected side in right-sided hemiplegia. This allows the client to pivot and transfer using their stronger side, improving balance and reducing the risk of falls. Proper positioning of the wheelchair also ensures a safer and more controlled transfer process.

C. Pivoting the client on the foot closest to the chair is incorrect because the pivot should occur on the client’s stronger, unaffected side. In right-sided hemiplegia, the right side is weak, so weight-bearing and pivoting should be supported through the left side. Incorrect pivoting increases instability and fall risk.

D. Reaching under the client’s arms to pull them up is unsafe because it can cause shoulder injury, including subluxation or nerve damage, especially in stroke clients with flaccid limbs. This technique also does not promote proper body mechanics for the nurse or controlled movement for the client. Safe transfers require use of transfer belts or assistive devices rather than lifting under the arms.