A nurse is caring for an older adult client who has dementia.
The client's family member asks why the provider will not prescribe a medication to calm the client down. Which of the following statements should the nurse make?
"It can increase their blood pressure.”.
"It can increase their risk for infection.”.
"It can increase their risk for falls.”.
"It increases their risk of experiencing a stroke.”.
The Correct Answer is C
Choice A rationale
While some medications can affect blood pressure, a primary concern with prescribing sedatives or tranquilizers to older adults with dementia is not typically an increase in blood pressure. The physiological effects of these medications in this population are more commonly associated with central nervous system depression, leading to other significant adverse events, rather than hypertension. Normal blood pressure is typically <120/80 mmHg.
Choice B rationale
There is no direct scientific link establishing that medications to calm clients with dementia primarily increase their risk for infection. While some medications might indirectly affect the immune system in certain contexts, the main contraindication for using calming medications in dementia patients is not heightened susceptibility to infections. Risk for infection is more related to other factors like immobility or compromised immune status.
Choice C rationale
Prescribing medications to calm older adults with dementia significantly increases their risk for falls. Many sedatives and antipsychotics cause central nervous system depression, leading to impaired balance, dizziness, drowsiness, and reduced cognitive function. These effects directly contribute to an elevated risk of falls, which can result in severe injuries like fractures in this vulnerable population.
Choice D rationale
While some psychotropic medications can have cardiovascular effects, increasing the risk of stroke is not the primary or most common reason for avoiding calming medications in older adults with dementia. The more immediate and significant concern is the increased risk of falls and other central nervous system-related adverse effects. Stroke risk is influenced by broader cardiovascular health.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Learning and memory deficits involve difficulties acquiring new information or recalling past events. While often present in Alzheimer's disease, the specific difficulty with multitasking, which requires planning and coordinating multiple cognitive processes, points to a higher-order cognitive impairment than solely learning and memory.
Choice B rationale
Executive function encompasses a set of higher-level cognitive processes necessary for goal-directed behavior, including planning, organizing, sequencing, problem-solving, and multitasking. Difficulty with multitasking specifically indicates an impairment in the ability to manage and coordinate multiple cognitive operations simultaneously.
Choice C rationale
Perceptual-motor deficits involve difficulties in integrating sensory information with motor responses, such as issues with hand-eye coordination or spatial awareness. While these can occur in Alzheimer's, multitasking primarily involves cognitive processing and planning rather than motor execution or perception.
Choice D rationale
Complex attention refers to the ability to sustain attention on multiple stimuli simultaneously or to switch attention efficiently between tasks. While related to multitasking, executive function more broadly describes the strategic planning and organization required to successfully execute multiple tasks.
Correct Answer is B
Explanation
Choice A rationale
Antipsychotic medications primarily target neurotransmitter systems like dopamine, commonly used for psychotic disorders such as schizophrenia or severe mood disorders with psychotic features. Avoidant personality disorder, characterized by social inhibition and hypersensitivity to negative evaluation, does not typically involve psychosis, thus antipsychotics are not a first-line treatment.
Choice B rationale
Interpersonal therapy focuses on improving interpersonal relationships and social functioning. For avoidant personality disorder, which involves significant social anxiety and avoidance due to fear of criticism, this therapy helps clients develop healthier communication patterns and navigate social interactions, directly addressing their core symptoms and improving their quality of life.
Choice C rationale
Dialectical behavior therapy is a specialized cognitive-behavioral therapy often used for borderline personality disorder, focusing on emotional regulation, distress tolerance, and interpersonal effectiveness. While some overlap in symptoms may exist, avoidant personality disorder's primary struggles are not typically the severe emotional dysregulation and impulsivity addressed by DBT.
Choice D rationale
Antidepressant medications, particularly SSRIs, are used to manage comorbid symptoms like anxiety or depression often seen in avoidant personality disorder. However, they do not directly address the underlying personality traits, maladaptive coping mechanisms, or interpersonal difficulties that define the disorder itself. Therapy is crucial for foundational change.
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