A nurse is assessing a client who has Alzheimer's disease. Which of the following findings should the nurse identity as the priority?

Rationale for correct choices:

• Ask a trusted person to watch for manifestations of illness: Involving a trusted person in monitoring symptoms can help identify early signs of relapse. Sometimes, clients may not notice subtle changes in their mental state, so a reliable individual can alert the healthcare provider, allowing for early intervention.
• Notify your provider within 48 hr of manifestations of a relapse: Early detection and intervention are key to preventing a full relapse. By notifying the provider within 48 hours, the healthcare team can adjust medications or other interventions promptly, reducing the severity of symptoms.
• Go for a walk to decrease anxiety during times of increased stress: Physical activity, like walking, is beneficial for managing anxiety, which is a common trigger in individuals with schizophrenia. Regular exercise can also promote mental well-being, making it a helpful strategy for coping with stress.
• Report any adverse effects of the medication to the provider immediately: Antipsychotic medications like haloperidol can cause significant side effects, and reporting these early allows the provider to manage or adjust the treatment plan, preventing complications such as extrapyramidal symptoms or neuroleptic malignant syndrome.

Rationale for incorrect choices:

• Limit alcohol consumption to no more than two drinks per week: Alcohol should be avoided entirely, as it can interfere with the effectiveness of antipsychotic medications and worsen psychiatric symptoms.
• Take a dose of the medication as soon as delusions or hallucinations begin: Medications for schizophrenia, like haloperidol, should be taken as prescribed, and adjustments to dosage or frequency should only be made under the guidance of a healthcare provider.

A. The client does not recognize their partner: While this is concerning, it is a common symptom of Alzheimer's disease as it progresses. However, it is not immediately life-threatening or a direct risk to the client’s safety.
B. The client places their shoes on the wrong feet: This is a typical manifestation of cognitive decline in Alzheimer's disease. While it may affect the client's independence, it is not an urgent issue that requires immediate intervention compared to other symptoms.
C. The client is unable to remember their personal history: Memory loss, especially related to personal history, is a hallmark symptom of Alzheimer's disease. Although it affects the client's cognitive function, it is not a crisis situation requiring priority intervention.
D. The client engages in wandering: Wandering is the priority concern in this scenario. It poses a significant safety risk, as the client may become lost, confused, or injured. Ensuring the client's safety by addressing wandering behavior is essential in managing Alzheimer's disease.