The nurse is attempting to de-escalate a client who is becoming increasingly agitated on the unit. Which of the following interventions would be appropriate for this type of client? (SELECT ALL THAT APPLY)

Choices A, C, and D: Changes to behavior and personality, Impaired judgment, Muscle stiffness and shuffling gait.

Choice A Reason:

Changes to behavior and personality are hallmark symptoms of frontotemporal dementia (FTD). This condition primarily affects the frontal and temporal lobes of the brain, which are responsible for behavior, personality, and language. Patients often exhibit socially inappropriate behaviors, apathy, and a decline in personal hygiene. These changes are among the earliest and most noticeable symptoms of FTD.

Choice B Reason:

While a past history of head trauma can be a risk factor for various types of dementia, it is not specifically associated with frontotemporal dementia. FTD is more commonly linked to genetic factors and specific protein abnormalities in the brain. Therefore, a history of head trauma is not a typical aspect of the medical history for FTD patients.

Choice C Reason:

Impaired judgment is a common symptom of frontotemporal dementia. The degeneration of the frontal lobes affects executive functions, including decision-making, problem-solving, and judgment. Patients may make poor decisions, exhibit risky behaviors, and have difficulty understanding the consequences of their actions.

Choice D Reason:

Muscle stiffness and a shuffling gait can occur in some forms of frontotemporal dementia, particularly in cases where the condition overlaps with motor neuron disease or Parkinsonism. These physical symptoms are less common than behavioral and cognitive symptoms but can still be present in some patients.

Choice E Reason:

A diagnosis of hypertension is not specifically related to frontotemporal dementia. While hypertension is a common condition that can coexist with any form of dementia, it is not a characteristic feature of FTD. The primary symptoms of FTD are related to changes in behavior, personality, and cognitive functions rather than vascular issues.

Choice A Reason:

It is extremely important to maintain professional boundaries with clients.

Maintaining professional boundaries is crucial in nursing to ensure a therapeutic and trusting relationship between the nurse and the client. Crossing these boundaries can lead to ethical issues and compromise the care provided. In this scenario, the nurse allowed personal relationships to influence professional behavior, which is inappropriate and can undermine the client’s trust and the integrity of the nurse-client relationship.

Choice B Reason:

Countertransference may have been a factor in your actions with this client.

Countertransference occurs when a nurse’s personal feelings and experiences influence their professional interactions with a client. In this case, the nurse’s familiarity with the client as a childhood friend of a sibling may have led to biased actions, such as allowing the use of a personal mobile device and sharing confidential information. Recognizing and managing countertransference is essential to maintain objectivity and provide unbiased care.

Choice C Reason:

It would have been better if you called your sibling instead of texting.

This statement is not relevant to the primary issues at hand. Whether the nurse called or texted their sibling does not change the fact that sharing the client’s hospitalization status was a breach of confidentiality. The focus should be on the inappropriate disclosure of protected health information, not the method of communication.

Choice D Reason:

Policies can be amended for clients who are admitted voluntarily, not involuntarily.

This statement is incorrect. Policies regarding the use of personal mobile devices and confidentiality apply to all clients, regardless of whether they are admitted voluntarily or involuntarily. The nurse’s actions violated these policies, and the distinction between voluntary and involuntary admission does not justify the breach.

Choice E Reason:

You have violated HIPAA regulations by notifying your sibling of the client’s admission.

This is the correct response. The nurse violated HIPAA regulations by disclosing the client’s hospitalization status to their sibling without the client’s consent. HIPAA protects the privacy of individuals’ health information, and unauthorized disclosure is a serious violation that can result in legal and professional consequences.