An older adult patient with Alzheimer's disease is admitted to the hospital. The patient's spouse reports that the patient is often confused and gets lost walking to the store, which is three blocks from their home
That evening, the nurse observes the patient pacing the hall and screaming. What will the nurse do? a. Notify the provider of this patient's wor-sening symptoms.
b. Prepare the patient's spouse for impending death from Alzheimer's disease.
c. Request an increase in the medication dose to treat the exacerbation in symp-toms.
d. Tell the spouse that this is an expected progression of the disease.
D
This patient is showing signs of the natural progression of AD. Behavior problems such as these occur in 70% to 90% of patients with AD as the disease progresses. There is no need to notify the provider to report these symptoms, because they are expected. The time from onset of symp-toms to death usually is 4 to 8 years, but it may be as long as 20 years; this progression does not represent the final stages. Medications are not effective for preventing disease progression, and their effects on memory and cognition are modest, so requesting an increase in the drug dose would not help in this situation.
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