A male client with a cognitive deficit becomes agitated and upset when he is unable to remember daily activities. Which should the nurse implement to facilitate congruent thought processes for the client? (Select all that apply.)
1. Reinforce the information provided.
2. Contact the family for more help.
3. Provide a large check-off calendar.
4. Tell the client not to worry about it.
5. Find an emergency client companion.
6. Explain medications with many details.
1, 3
1. The nurse reinforces information provided to the client frequently and without fanfare to facilitate congruent thought processes. The client is already upset and aware of his impaired cognitive abilities; the nurse is less likely to increase client distress and anxiety by reinforcing information objectively and calmly.
3. The nurse develops a calendar of household activities with the client and provides an easy method of checking off the completed items; if the client forgets a task is completed, he can see its status by looking at the calendar.
1. Contacting the family implies that the client is incapable of any self-care and it is unlikely to provide encouragement or positive feedback.
4. Telling the client not to worry is trivializing a client concern.
5. The client does not need a companion yet.
6. Explanations for a client with a cognitive impairment should begin with simple, consistently applied instructions that are explained to the client, backed up with print material, and reinforced with repetition. The client is more likely to be able to follow simple instructions and this can contribute to
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