A woman with Alzheimer's disease has significant apraxia and poor hygiene. Which intervention would be most appropriate for ensuring that the patient completes a shower?
a. Remind her of the need for a shower and where the shower is, and repeat this every 30 minutes until the shower is completed.
b. Discuss with her the importance of showers as part of daily self-care, and elicit and resolve any obstacles to the patient's showering.
c. Walk her to the shower, and provide occasional reminders of what she should do next if she seems to be unsure or begins to repeat previous actions.
d. Walk her to the shower, assist her to undress, start the water, supply the soap and washcloth, and instruct her to rub her face with the washcloth.
D
Apraxia is the inability to complete tasks despite having the sensory and motor capacity to do so. It is seen in significant levels in stage 3 Alzheimer's disease and requires the full assistance of a caregiver or staff person, who must patiently provide simple, concrete, step-by-step directions, with each direction given one at a time when the patient is ready to progress to the next step. Simply reminding the patient to shower, educating her about hygiene, assisting her to go to the shower room, or providing reminders would not be therapeutic for patients with significant apraxia. They lack the ability to remember or enact any of the steps involved in a complex task and require directions for each action and step involved in the process.
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A goal for a patient with impulsive behavior is "The patient will explore the causes and consequences of impulsive behavior.". A strategy that will best assist the patient in achieving this goal is:
a. using rewards for appropriate behavior. b. using relaxation exercises to reduce interpersonal anxiety. c. keeping a diary to describe events before and after the behavior. d. frequent clinical supervision for the nurse providing therapy for the patient.
A nurse has completed the assessment for a patient who has a maladaptive response to eating regulation
Findings include: height, 5 feet 3 inches; current weight, 80 pounds with weight loss of 30% of body weight; poor skin turgor; lanugo; amenorrhea of 6 months' duration; and admits to restricting intake to 350 calories daily. These assessment findings are most consistent with the medical diagnosis of: a. bulimia nervosa. b. anorexia nervosa. c. binge-eating disorder. d. disturbed body image.
List four methods of enabling that the nursing assistant should avoid.
What will be an ideal response?