A nurse is assessing a client diagnosed with schizophrenia who has been treated with fluphenazine (Prolixin) for several years. Which of the following findings should the nurse document as manifestations of tardive dyskinesia (TD)?

Choice A Reason:

Becoming lost in a usually familiar environment is a significant early warning sign of Alzheimer's disease. This symptom indicates spatial disorientation and memory loss, which are common in the early stages of the disease. Individuals may forget familiar routes or become confused about their location, even in places they know well.

Choice B Reason:

Difficulty performing familiar tasks is another early warning sign of Alzheimer's disease. This can include challenges with routine activities such as cooking, managing finances, or using household appliances. The inability to complete tasks that were once easy and familiar is a key indicator of cognitive decline.

Choice C Reason:

Losing sense of time is a common symptom in the early stages of Alzheimer's disease. Individuals may forget dates, seasons, or the passage of time. They might also have trouble understanding something if it is not happening immediately. This disorientation can lead to confusion and difficulty planning or following schedules.

Choice D Reason:

Misplacing car keys is a common occurrence and not necessarily an early warning sign of Alzheimer's disease. While everyone misplaces items occasionally, it becomes a concern when individuals consistently place items in unusual locations and cannot retrace their steps to find them. However, this alone is not a definitive sign of Alzheimer's.

Choice E Reason:

Problems with performing basic calculations are indicative of cognitive decline associated with Alzheimer's disease. Individuals may struggle with simple arithmetic, balancing a checkbook, or managing finances. This difficulty with numbers and calculations is a common early symptom of the disease.

Choice A reason:

Asking the client "Why do you think you might have cancer when your diagnosis is a benign condition?" could be perceived as dismissive of the client's feelings. It's important for the nurse to acknowledge the client's concerns rather than questioning their rationale.

Choice B reason:

While it is true that discussing specific medical concerns with a provider is important, the statement "I think that's something you need to discuss with your provider" does not address the client's immediate emotional needs. The nurse should provide support and acknowledge the client's feelings before suggesting a discussion with the provider.

Choice C reason:

The response "I'm hearing that you are concerned that it might turn out that you have cancer" is an example of reflective listening. It shows that the nurse is actively listening and validating the client's concerns. This approach can help the client feel understood and supported during a stressful time.

Choice D reason:

Saying "I'm looking at your chart here and I don't see any reason for you to worry about that" may seem reassuring, but it does not validate the client's feelings. The nurse should acknowledge the client's fears and provide comfort, rather than simply referring to the medical facts.