Alzheimer’s Delirium and Dementia Q 18
Nurse Ronald could evaluate that the staff’s approach to setting limits for a demanding, angry client was effective if the client:
A. Apologizes for disrupting the unit’s routine when something is needed.
B. Understands the reason why frequent calls to the staff were made.
C. Discuss concerns regarding the emotional condition that required hospitalizations.
D. No longer calls the nursing staff for assistance.
Correct Answer: C. Discuss concerns regarding the emotional condition that required hospitalizations
This would document that the client feels comfortable enough to discuss the problems that have motivated the behavior. Chart, in nurse’s notes, behaviors; interventions; what seemed to escalate agitation; what helped to calm agitation; when as-needed (PRN) medications were given and their effect; and what proved most helpful. Staff will begin to recognize potential signals for escalating manic behaviors and have a guideline for what might work best for the individual client.
Option A: Frequently assess client’s behavior for signs of increased agitation and hyperactivity. Early detection and intervention of escalating mania will prevent the possibility of harm to self or others, and decrease the need for seclusions. Use a calm and firm approach. Provides structure and control for a client who is out of control.
Option B: Remain neutral as possible; Do not argue with the client. The client can use inconsistencies and value judgments as justification for arguing and escalating mania. Use short, simple, and brief explanations or statements. Short attention span limits understanding of small pieces of information.
Option D: Maintain a consistent approach, employ consistent expectations, and provide a structured environment. Clear and consistent limits and expectations minimize potential for client’s manipulation of staff. Redirect agitation and potentially violent behaviors with physical outlets in an area of low stimulation (e.g., punching bag). Can help to relieve pent-up hostility and relieve muscle tension.