An older woman with dementia exhibits new behaviors including crying and repeatedly verbalizing the same phrase; further, the behavior has increased over 2 days. Which intervention should the nurse implement in response to this behavior?

Question

a. Tell her you will remember what she says if she stops crying.
b. Attribute these findings to a deterioration in cognitive function.
c. Check the medication administration record for missed doses.
d. Present probing questions to the patient about her behavior.

Answer 1

C
New behaviors with increasing frequency warrant further investigation by the nurse to ensure that effective nursing care can be planned and implemented. Crying and repeated verbalizations from a patient with dementia can indicate anxiety, but the cognitive disorder makes anxiety dif-ficult to detect. In addition to checking for missed doses, the nurse checks the medication record for medications that are likely to cause anxiety, such as beta-adrenergic agonists, which are used to reverse bronchoconstriction. The nurse should also check for risk factors for anxiety and per-form a comprehensive assessment to identify potential causes.
The nurse should avoid making a veiled threat to the patient. Giving the patient the in-centive to stop crying can be suitable; however, the incentive should never be attention; the duty of the nurse is to pay close attention to the patient. The new behavior can be deteriorating cogni-tive function, but the nurse must first assess the patient further before making that determination. One aspect of the assessment is to question the patient. Depending on the stage of dementia, the patient can be an unreliable source of information about herself.