Medical Surgical Dementia vs Delirium #3

Question

The nurse is caring for a client with dementia and is concerned for impaired social interaction. Which intervention should the charge nurse intervene?

Answers

  1. Approaching the client from the front and speaking in short sentences slowly.
    • Rationale:

      This answer is not correct because it is not the appropriate way to approach a client with dementia. Approaching from the front and speaking in slow, short sentences helps their brain process your approach and your words.

  2. Reminisce with the client about his time in the Army.
    • Rationale:

      This answer is not correct because reminiscing about past events from long ago does not require short-term recall. A client with dementia may recall events from years prior but not remember what they ate for breakfast.

  3. Including the client in a small birthday party for another resident.
    • Rationale:

      This answer is not correct because although avoiding an over-stimulating environment is important, a small birthday party would not be overstimulating for the client and may help the client feel included. Lots of noise, chaos, and activity can overload the senses in the client with dementia.

  4. Correcting the client's thought process as it relates to reality.
    • Rationale:

      This answer is correct because correcting the thought process of a dementia client can potentially be upsetting and cause embarrassment. Avoid trying to reorient the person if it is not safe to do so. Validation and entering the client’s reality is much more fruitful and promotes self worth.

Overview

Social interaction for the client with dementia involves having positive experiences with their caregivers and others. This will result in the client becoming less isolated or withdrawn.

Explanation

Learning Outcomes

Studies show that keeping the client communicative and involved can slow down the progression of dementia. By involving the client in activities and reminiscing, the nurse is increasing the self-confidence and self-esteem of the client living with dementia. Always remember the person behind the dementia. Enter their reality and look for ways to validate them. Using short, simple sentences, and speaking slowly will help the client process what you are saying. Establishment in reality is not necessary for the client with dementia. Visiting their reality with them will help them feel safe and secure.

Test Taking Tip

The client with dementia may experience an impaired sense of self. Choose answers that promote dignity and safety.

Video Rationale