A nurse is caring for a client with Alzheimer’s disease who has difficulty remembering recent events.

Which of the following interventions is appropriate for the nurse to implement?

The correct answer is B.

Provide the client with a calendar and a clock to promote orientation.This intervention helps the client with Alzheimer’s disease to maintain a sense of reality and reduce confusion by providing cues for time and date.

Choice A is wrong because asking the client to repeat information several times to enhance retention may increase frustration and anxiety for the client, as he or she may not be able to recall the information due to impaired memory.

Choice C is wrong because avoiding using reminiscence therapy as it may increase confusion is not supported by evidence.Reminiscence therapy is a type of intervention that involves recalling and sharing past experiences with others, which can improve mood, cognition, and socialization for clients with Alzheimer’s disease.

Choice D is wrong because correcting the client’s mistakes or inaccuracies to improve memory may also cause frustration and agitation for the client, as he or she may not be aware of the errors or may feel criticized or embarrassed.

Normal ranges for cognitive function can be assessed using tools such as the Mini-Mental State Examination (MMSE) or the Montreal Cognitive Assessment (MoCA), which measure orientation, attention, memory, language, and executive function.

The MMSE has a maximum score of 30, with scores below 24 indicating cognitive impairment.The MoCA has a maximum score of 30, with scores below 26 indicating mild cognitive impairment.

A. Ask the client to repeat information several times to enhance retention.

B. Provide the client with a calendar and a clock to promote orientation.

C. Avoid using reminiscence therapy as it may increase confusion.

D. Correct the client’s mistakes or inaccuracies to improve memory.

The correct answer isA, C and E.

These are the factors that the nurse should ask about when suspecting vascular dementia.

Vascular dementia is caused by different conditions that interrupt the flow of blood and oxygen supply to the brain and damage blood vessels in the brain.People with vascular dementia almost always have abnormalities in the brain that can be seen on MRI scans.These abnormalities can include evidence of prior strokes, which are often small and sometimes without noticeable symptoms.

Choice Ais correct becausehypertension(high blood pressure) is one of the risk factors for vascular dementia, as it can damage the small blood vessels in the brain and reduce blood flow.Controlling blood pressure may help lower the chances of developing vascular dementia.

Choice Bis wrong becausefamily history of Alzheimer’s diseaseis not a factor for vascular dementia, but for Alzheimer’s disease, which is a different type of dementia.Alzheimer’s disease is caused by abnormal protein deposits in the brain, not by impaired blood flow.

Choice Cis correct becausetransient ischemic attacks(TIAs), also known as mini-strokes, are another risk factor for vascular dementia, as they can damage brain cells and affect cognition.TIAs are temporary episodes of reduced blood flow to the brain, causing symptoms similar to a stroke but lasting only a few minutes or hours.

Choice Dis wrong becauseexposure to environmental toxinsis not a factor for vascular dementia, but for other types of dementia, such as Lewy body dementia or Parkinson’s disease dementia.These types of dementia are caused by abnormal protein deposits in the brain or nerve cell damage, not by impaired blood flow.

Choice Eis correct becausediabetes mellitusis another risk factor for vascular dementia, as it can damage the blood vessels and increase the risk of stroke and heart disease.Controlling blood sugar may help lower the chances of developing vascular dementia.

Sources:.

:Vascular Dementia: Causes, Symptoms, and Treatments | National Institute on Aging.

:Vascular dementia - Symptoms & causes - Mayo Clinic.

:causes of vascular dementia - NHS - NHS.

A. History of hypertension B.

Family history of Alzheimer’s disease C.

History of transient ischemic attacks D.

Exposure to environmental toxins E.

History of diabetes mellitus