An older resident of a long-term care facility diagnosed with dementia has in the last 48 hours become more confused than usual and while usually requiring help with toileting has been incontinent of urine. The client's healthcare provider orders a comple

Question

a. attributes the changes in the resident's functioning to advancing dementia
b. suggests that the resident be placed on broad-spectrum antibiotics to prevent infections
c. speaks with the healthcare provider regarding the changes in the client's function and the possibility of obtaiing a urine culture
d. changes the plan of care to include bladder training and implement a 24-hour calorie count.

Answer 1

ANS: C
Waiting for usual signs of infection or illness in older adults can be fatal. In older adults, signs of infection may be absent or not seen until the patient is septic or very ill. The nurse needs to be alert to the subtle changes in the patient. Laboratory values do not always change in older adults, often not until the patient is very ill. Infections are not prevented by placing a patient on broad-spectrum antibiotics. This action may in fact cause bacteria to become drug resistant. All evidence points to the changes in functioning being attributable to acute illness. The nurse needs to respond to the acute illness first.