A 78-year-old nursing home resident with hypertension and cardiac disease is usually alert and oriented. This morning, however, the resident says, "My family visited during the night. They stood by the bed and talked to me."

Question

In reality, the patient's family lives 200 miles away. The nurse should first suspect that the resident:

a. may have a cognitive impairment associated with medication effects.
b. may be developing Alzheimer‘s disease associated with advanced age.
c. had a transient ischemic attack and developed sensory perceptual alterations.
d. has a previously unidentified alcohol dependency and is beginning alcohol withdrawal delirium.

Answer 1

ANS: A
A resident taking medications is at high risk for becoming confused because of medication side effects, drug interactions, and delayed excretion. The nurse should report the event and continue to assess for cognitive impairment. Symptoms of dementia develop slowly but persist over time. Alcohol dependency and withdrawal are not the nurse's first suspicion in this scenario.