Which of the following assessment data best confirms the possibility of cognitive impairment in a client with a diagnosis of lung cancer?
1. Client is observed writing questions to ask his oncologist.
2. Client states, "I seem to be a little more forgetful lately."
3. Client's wife states, "I have to remind him of everything."
4. Client overheard asking son, "Where did I put my glasses?"
ANS: 2
Cognitive changes are a set of physical symptoms very common in survivors that develop from their disease, treatment, the complications of treatment, underlying medical conditions, and psy-chological responses to the diagnosis of cancer (Nail, 2006). Cognitive changes can occur during all phases of the cancer experience, from small deficits in information processing to acute deliri-um. Often the cognitive impairments survivors experience are not evident to someone else but are apparent to the person experiencing them, especially in relation to work performance with high cognitive demands (Anderson-Hanley and others, 2003). The client's personal evaluation of his memory is the best indicator of cognitive impairment.
While writing down questions to ask the oncologist may be motivated by poor memory, it is not uncommon for clients to prepare a list of questions before a meeting with their health care pro-vider.
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