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A nurse is teaching clients at a senior center about the etiology of Alzheimer's disease. Which of the following statements by a client indicates the need for further teaching?

"Since my parent suffered from Alzheimer's disease, I know that I am at an increased risk for developing the disease myself."

"The cause of Alzheimer's disease is still not fully known or understood."

"l do not have to worry about this because I do not have Down syndrome and I have never had a stroke."

"My child is at risk for developing Alzheimer's disease because they have trisomy 21."

Answer and Explanation

The Correct Answer is C

A. "Since my parent suffered from Alzheimer's disease, I know that I am at an increased risk for developing the disease myself." This statement is accurate. Family history is a significant risk factor for Alzheimer's disease. Individuals with a first-degree relative (such as a parent or sibling) with Alzheimer's disease are at a higher risk of developing the condition themselves.

B. "The cause of Alzheimer's disease is still not fully known or understood." This statement is also accurate. While there are theories about the underlying causes of Alzheimer's disease, such as genetics, brain changes, and environmental factors, the exact cause is still not fully understood. Research into the etiology of Alzheimer's disease is ongoing.

C. "I do not have to worry about this because I do not have Down syndrome and I have never had a stroke." This statement indicates a need for further teaching. While it is true that individuals with Down syndrome and those who have had a stroke are at increased risk for developing Alzheimer's disease, they are not the only populations at risk. Alzheimer's disease can affect individuals without Down syndrome or a history of stroke. Other risk factors include age, family history, genetics, and lifestyle factors.

D. "My child is at risk for developing Alzheimer's disease because they have trisomy 21." This statement is accurate. Trisomy 21, also known as Down syndrome, is associated with an increased risk of developing Alzheimer's disease. Individuals with Down syndrome have three copies of chromosome 21, which contains the gene for amyloid precursor protein (APP). Overproduction of amyloid beta protein, derived from APP, is thought to contribute to the development of Alzheimer's disease in individuals with Down syndrome.

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Correct Answer is D

Explanation

A. White blood cell level of 5,900 mm3: While abnormal white blood cell levels can indicate infection or inflammation, they are not typically associated with directly contributing to an episode of delirium. However, underlying conditions that cause abnormal white blood cell levels, such as infection or inflammation, may contribute to delirium.

B. Potassium level of 4.1 mEq/L: Potassium imbalances can lead to various neurological symptoms, including weakness, paralysis, and cardiac arrhythmias. However, a potassium level of 4.1 mEq/L is within the normal range and is unlikely to directly contribute to an episode of delirium.

C. Hemoglobin level of 14.2 g/dL: Hemoglobin levels reflect the oxygen-carrying capacity of the blood and are not directly associated with delirium. While severe anemia or hypoxia can cause neurological symptoms, a hemoglobin level of 14.2 g/dL is within the normal range and is unlikely to directly contribute to delirium.

D. Blood glucose level of 254 mg/dL: Elevated blood glucose levels, as indicated by a blood glucose level of 254 mg/dL, can contribute to an episode of delirium. Hyperglycemia can lead to alterations in cerebral metabolism, neuronal dysfunction, and impaired cognitive function, predisposing individuals to delirium. Additionally, hyperglycemia can exacerbate preexisting neurological conditions and increase the risk of developing delirium in critically ill patients. Therefore, monitoring and managing blood glucose levels are essential in preventing and managing delirium in hospitalized patients.

A. Lower blood pressure. B. Decrease sedation C. Hyperventilate the client. D. Reduce the temperature in the room.

Correct Answer is C

Explanation

A. Lower blood pressure: Lowering blood pressure may be indicated in certain cases of brain herniation to reduce cerebral perfusion pressure (CPP) and decrease cerebral blood volume. However, this intervention should be carefully titrated based on the individual client's condition and should not be applied universally as a treatment for brain herniation. In some cases, lowering blood pressure may exacerbate cerebral ischemia and worsen neurological outcomes.

B. Decrease sedation: Reducing sedation may be necessary to allow for neurological assessment and evaluation of the client's neurological status. However, it is not a direct treatment for brain herniation. Sedation may need to be adjusted to facilitate neurological monitoring and assessment of the client's response to treatment interventions. Excessive sedation can obscure neurological signs and symptoms, making it difficult to assess the effectiveness of interventions aimed at reducing ICP.

C. Hyperventilate the client: Hyperventilation is a potential intervention for managing brain herniation as it helps temporarily lower intracranial pressure (ICP) by inducing cerebral vasoconstriction. By increasing the rate and depth of breathing, hyperventilation reduces the partial pressure of carbon dioxide (PaCO2) in the blood, leading to vasoconstriction of cerebral blood vessels and a decrease in cerebral blood flow. This can help alleviate symptoms associated with increased ICP and reduce the risk of further brain injury.

D. Reduce the temperature in the room: Therapeutic hypothermia may be considered as a treatment option in certain cases of brain injury to reduce metabolic demand, lower ICP, and attenuate secondary brain injury. However, simply reducing the temperature in the room without implementing therapeutic hypothermia protocols is unlikely to effectively manage brain herniation. Therapeutic hypothermia requires careful monitoring and control of the client's body temperature to prevent complications. Additionally, hypothermia alone may not provide immediate relief from increased ICP associated with brain herniation.

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A nurse is teaching clients at a senior center about the etiology of Alzheimer's disease. Which of the following statements by a client indicates the need for further teaching?

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