Neurocognitive Disorder due to Alzheimer’s Disease Case Study – Flashcards

C. "You look worried. How can I make you feel more comfortable?" This response acknowledges the clients feelings and the word "worried" is generally neutral.

A. Advancing age. D. Father and uncle had Alzheimer's disease. E. Previous head trauma. The risk for developing Alzheimer's disease increases as age advances. A family history is a known risk factor for Alzheimer's disease. There is an association between a history of head trauma and Alzheimer's disease, particularly repeated head trauma.

A. "Changes in behavior and personality often occur as Alzheimer's disease progresses." Subtle changes in behavior and personality, which would easily be recognized by a loved one, occur even in early AD.

B. "If you smelled smoke in a movie theater, what would you do?" This question elicits the most information about judgment. The client must know what a fire is and describe how he would react.

C. "I appreciate your cooperation. Tell me what you think is the problem." This acknowledges the client's concerns and engages him in his own care as much as possible. Giving the client some control may decrease his anxiety.

B. Forgets the purpose or use of an item. C. Cooks a meal and forgets to serve it. E. Becomes lost on the client's own street. This type of memory loss is associated with Alzheimer's disease.

B. "Everyone responds differently to this disease, but it is likely that his health and daily functioning will continue to decline." This is the most accurate description of this disease, and it allows the client's daughter to participate in her father's plan of care.

C. Maintaining optimum function. There is not a cure for Alzheimer's disease, but support can help the client and the client's family live at a maximum level.

A. Delirium Recent onset along with visual hallucinations indicates a possible delirium.

C. Make sure her father's room has sufficient light. E. Divert her father's attention with food or drink. Shadows can increase confusion and support delusions. Night time confusion can be reduced by diverting the client to something familiar and soothing.

A. Enhancing Acetylcholine function. Donepezil (Aricept) prevents an enzyme known as acetylcholinesterase from breaking down acetylcholine in the brain. Increased concentrations of acetylcholine lead to increased communication between the nerve cells that use acetylcholine as a chemical messenger, which may temporarily improve or stabilize the symptoms of Alzheimer's disease.

A. Tarry stool. A bloody, black, or tarry stool may indicate GI bleeding, a serious side effect of the medication.

B. Serum liver enzymes. Liver toxicity is a significant side effect of acetylcholinesterase inhibitors, so liver function tests should be monitored regularly.

A. The client will maintain the highest level of cognitive ability. Donepezil (Aricept) slows cell destruction.

D. Mr. Caudill's eyes water each time he swallows a bite of meat or bread. Watering eyes during swallowing could indicate silent aspiration or choking, and it requires immediate medical evaluation. During the late stages of Alzheimer's disease, individuals can lose the mechanical ability to swallow, and they are at increased risk for aspiration.

A. Mr. Caudill sleeps through the night. Trazodone (Desyrel) is an antidepressant often used to improve sleep in the client with AD.

C. Mr. Caudill has a weak and thready pulse. A weak and thready pulse may indicate severe vascular dehydration and should be reported immediately.

A. Appointment of another person to make healthcare decisions if the client is unable. B. Specific or general instructions about physical healthcare treatment. D. Specific or general instructions about mental or psychological healthcare treatment. Also known as a durable power of attorney, this can be a part of an advance directive for healthcare. It names another person to make healthcare decisions if the individual is mentally or physically unable. Decisions or preferences about physical, mental, or psychological healthcare treatment such as the use or nonuse of a ventilator can be outlined in an advance directive for healthcare or electrical shock treatment can be outlined in an advance directive for healthcare.

B. "I will pull up a chair so that you may sit on the left side of the bed and hold his hand." Mr. Caudill's daughter's presence may make the procedure safer and less traumatic.

B. "You are right to balance his feelings with the need to promote reality." Reality orientation is an important tool for the client with AD, but, as the disease progresses, it often causes the client to become agitated. It is important to recognize the feelings and emotions of the client with AD.

B. Keep the room well lit during the evening hours. Adequate lighting can decrease agitation that occurs when surroundings are unfamiliar or dark. Reduced lighting and increased shadows can cause the client with Alzheimer's disease to misinterpret what they see.

A. Redirect Mr. Caudill's attention to a familiar object from his home. The nurse should first attempt to calm the client by redirecting his attention or distracting him from the source of the anxiety.

A. Evaluate Mr. Caudill's vital signs before transferring him to his bed. Mr. Caudill may be experiencing an adverse effect of the medication, and he should be assessed before further action is initiated.

D. Elevate Mr. Caudill's feet fifteen degrees. Mr. Caudill is experiencing hypotension secondary to his initial dose of the antipsychotic medication. The priority nursing action is to restore his blood pressure.

A. Reports of physical symptoms such as frequent headaches. B. Feels a sadness that will not go away. D. Frequently forgets to change care recipient's soiled linens. E. Withdraws from family and friends. Reports of frequent physical symptoms are a sign of caregiver stress. Mental health issues, including depression, are prevalent among caregivers of clients with chronic illnesses such as Alzheimer's disease. Abuse or neglect is sometimes associated with increased caregiver stress or burden. Caregivers who are experiencing stress often withdraw from family, friends, and social activities.

B. "What do you find most stressful in your daily life?" This question will focus the caregiver on the daughter's needs.

D. "You have many conflicting emotions right now." This response restates the daughter's feelings and provides the opportunity for her to continue to share concerns.