A nurse is assessing a client who has Lewy body dementia. The nurse should recognize that which of the following is responsible for changes in thinking, communication, movement, and emotional processing in Lewy body dementia?

A. "Note if you see any flashing bright lights on the grid." Flashing lights are not typically associated with macular degeneration. This symptom is more commonly associated with conditions like retinal detachment or migraine headaches.

B. "Check to see if the lines on the grid are blurry or distorted." This statement is correct. The Amsler grid is used to detect changes in central vision, which are common in macular degeneration. Patients with macular degeneration may perceive wavy or distorted lines instead of straight lines when looking at the grid, indicating central vision loss.

C. "Monitor for the lines on the grid to change in color or brightness." Changes in color or brightness of the lines on the grid are not typical features of macular degeneration. This statement does not accurately reflect the purpose of using an Amsler grid for macular degeneration.

D. "Watch for floating dark spots on the grid." Floating dark spots (floaters) are not typically associated with macular degeneration. Floaters are more commonly associated with conditions like posterior vitreous detachment or retinal detachment.

A. Hypovolemic shock: Hypovolemic shock occurs due to a significant decrease in circulating blood volume, leading to inadequate tissue perfusion. Blood loss, such as that experienced by the client in the scenario, is a common cause of hypovolemic shock. The decrease in blood pressure observed over time is consistent with the compensatory mechanisms of hypovolemic shock, where the body attempts to maintain perfusion to vital organs despite decreased blood volume.

B. Septic shock: Septic shock results from a systemic inflammatory response to infection, leading to vasodilation, increased capillary permeability, and maldistribution of blood flow. While infection can lead to hypovolemia in some cases, the scenario does not provide evidence of infection or systemic inflammatory response as the cause of shock.

C. Obstructive shock: Obstructive shock occurs when there is obstruction to blood flow within the cardiovascular system, such as in cases of pulmonary embolism, cardiac tamponade, or tension pneumothorax. There is no evidence in the scenario to suggest an obstruction to blood flow as the cause of the client's shock.

D. Neurogenic shock: Neurogenic shock results from loss of sympathetic tone leading to vasodilation and relative hypovolemia. It is often associated with spinal cord injury or severe head injury. While neurogenic shock can lead to hypotension, the scenario does not indicate any neurological injury or insult as the cause of the client's shock.