The nurse is performing an admission assessment on a client with cognitive impairment. When developing a plan of care for this client, the nurse should plan to

Question

a. provide instructions one step at a time.
b. offer several instructions at a time when orienting the client to their room.
c. teach the client new skills using complex instructions with multiple steps.
d. refrain from mentioning the client's past life experiences when asking questions.

Answer 1

ANS: A
Cognitively impaired clients have trouble following instructions consisting of multiple steps. Breaking instructions into single steps helps these clients master tasks that otherwise are beyond their comprehension. Keep the conversation simple and focused on one step at a time. Asking mild to early moderate cognitively impaired older adults about their past life experiences is a way to connect verbally with those who might have difficulty telling you what they had for breakfast 2 hours ago. Remote memory (recall of past events) is retained longer than memory for recent events. When cognitively impaired adults share memories, they are giving a gift to the nurse by sharing part of themselves when they may have very little else to give.