Question

Edwards has been admitted to room 337 with mental status changes. When you come to the room, his oldest daughter is at his side and explains her concerns. Mr. Edwards’ daughter states that this morning he had gone for his usual walk in the neighborhood, but had become lost on his way home. She has noted other incidences of memory lapses such as his forgetfulness of recent events and disorientation of time, place, and situation.

1. Mr. Edwards’ daughter asks “I don’t know what to do. I work and I can’t stay with Dad 24 hours a day.” What items of help could you offer to the daughter?
2. What is important for the nurse to remember in talking with Mr. Edwards?
3. Mr. Edward’s daughter is concerned about medications being ordered for her father. She asks if there are harmful side effects she should be alert for and how do the drugs work? What teaching could you do?
4. Mr. Edward’s daughter asks how can the healthcare provider be sure her father has dementia? Review with her the basic methods used to diagnose dementia.

Answer 1

As she cannot be with him all the time you can offer thinking about care setting like Home Care , Retirement complex, Assisting living, and Nursing home.

While talking to Edward nurse should keep in mind that

• He often forgets
• Don't get frustrated
• Talk on his level of communication
• Correct him if he is confused
• Talk to him directly
• Use gentle touch

Make sure medication is kept organized and get base line of how he was before medication. Monitor him. The medication improves mental function , lowers blood pressure and enhance mood. The drugs may be cholinesterase inhibitors. It will the breakdown of neurotransmitter acetylcholine and thus improves concentration and memory. Some of the side effects are :

• Nausea
• Vomiting
• Loss of appetite
• More frequent bowel movements
• Bruising
• Muscle cramps
• Headaches
• Fatigue
• Insomnia

Medical assessment for dementia generally includes :

1) Medical history

2)physical examination

3) Neurological tests :Assessing balance, sensory response, reflexes, and other cognitive functions.

Cognitive and neuropsychological tests:

These tests are used to assess memory, problem solving, language skills, math skills, and other abilities related to mental functioning.