Medical Surgical Dementia vs Delirium #2

Question

A client with dementia tells the nurse she used to work as a lion tamer in the circus and had her arm bitten off by the lion. The nurse knows that the client is a retired school teacher and both upper extremities are intact. What is this an example of?

Answers

  1. Flight of ideas
    • Rationale:

      This answer is not correct because flight of ideas is when someone experiences a rapid flow of thoughts and has incessant hurried speech about different ideas or topics all at once. This is seen in clients with bipolar disorder or schizophrenia.

  2. Schizophasia
    • Rationale:

      This answer is not correct because schizophasia are words or phrases put together haphazardly in an indescribable manner. This is also called a “word salad” and is a symptom of dementia and seen in those with brain injuries.

  3. Tangential speech
    • Rationale:

      This answer is not correct because tangential speech is a communication disorder where the speaker does not focus and wanders off the topic. It is caused by thought disorder and experienced by those with schizophrenia, delirium, or dementia.

  4. Confabulation
    • Rationale:

      This answer is correct because the nurse knows the client was a school teacher and did not have her arm bitten off as evidenced by her intact upper extremities. Making up false memories spontaneously, as this client did is confabulation. This is done without deceit and the client believes what they are saying.

Overview

Confabulation is when a client creates false memories impulsively due to confusion or memory loss. This is unintentional on the client’s part, as the client believes their fabrication.

Explanation

Learning Outcomes

Confabulation is when a client impulsively creates false memories due to confusion or memory gaps. This is done without deceit and the client believes what they are saying. It is caused by memory loss. The areas of the brain associated with confabulation is the frontal lobe and basal forebrain. It is deemed best when speaking with a dementia client who is confabulating to join in their reality, instead of correcting. Validate what they are saying, as it is respectful and preserves their dignity. It helps them communicate more and be less withdrawn.

Test Taking Tip

In the word confabulation, think “conFIBulation”. It is a made up story or “fib”.

Video Rationale