An older adult diagnosed with moderate dementia is seen in the geriatric clinic. As the nurse is evaluating the client, the client's wife states that her husband has developed an increasing number of episodes of incontinence. She does not know what is precipitating the episodes, and states "maybe he just doesn't remember that he needs to urinate or maybe it's me, it takes me a while to walk him to the bathroom." The nurse develops a plan of care for this client and includes which of the following interventions to manage the incontinence? (Select all that apply.)

Choice A reason: This is a correct answer because Alzheimer's disease affects the brain cells and causes them to degenerate and die. This leads to a gradual decline in cognitive abilities, such as memory, language, reasoning, and problem-solving.

Choice B reason: This is a correct answer because Alzheimer's disease interferes with the daily activities and routines of the affected person. They may experience a decline from their previous level of functioning, such as forgetting appointments, misplacing items, or getting lost.

Choice C reason: This is an incorrect answer because easily frustrated is not a specific outcome of the early stage of Alzheimer's disease. Although some people with Alzheimer's disease may become frustrated, irritated, or angry due to their cognitive impairment, this is not a universal or diagnostic symptom.

Choice D reason: This is a correct answer because Alzheimer's disease affects the short-term memory first, causing the person to forget recent events, conversations, or names. This is called mild memory loss, and it is one of the most common signs of the early stage of Alzheimer's disease.

Choice E reason: This is a correct answer because Alzheimer's disease affects the frontal lobe of the brain, which is responsible for executive functions, such as planning, organizing, decision-making, and judgement. This leads to impaired judgement, such as making poor financial choices, neglecting personal hygiene, or acting inappropriately.

Choice A reason: This is the correct answer because the nurse should assess the patient's pain level and location, even if he denies pain. The patient's vital signs indicate that he may be experiencing pain, as increased heart rate, respiration rate, and blood pressure are common physiological responses to pain. Pain can also be masked by other factors, such as fear, anxiety, or stoicism. Therefore, the nurse should ask the patient about his comfort and use a valid pain assessment tool, such as the numeric rating scale or the faces pain scale, to measure his pain intensity.

Choice B reason: This is incorrect because the nurse should not administer an opioid medication by IV route without assessing the patient's pain level and location first. Opioid medications are potent analgesics that can relieve severe pain, but they can also cause serious side effects, such as respiratory depression, sedation, nausea, vomiting, constipation, or dependence. The nurse should follow the principles of pain management, such as using the lowest effective dose, titrating the dose according to the patient's response, and monitoring the patient for adverse effects. The nurse should also consider using non-pharmacological interventions, such as ice packs, elevation, or distraction, to complement the pharmacological therapy.

Choice C reason: This is incorrect because the nurse should not check the surgical dressing for bleeding without assessing the patient's pain level and location first. Checking the surgical dressing for bleeding is an important intervention to monitor the patient's wound healing and prevent infection, but it is not the priority in this scenario. The nurse should first assess the patient's pain and provide appropriate pain relief, as pain can impair wound healing and increase the risk of complications. The nurse should also obtain the patient's consent and explain the procedure before checking the surgical dressing, as this can cause discomfort and anxiety.

Choice D reason: This is incorrect because the nurse should not report the vital signs to the health care provider without assessing the patient's pain level and location first. Reporting the vital signs to the health care provider is an important intervention to communicate the patient's condition and obtain further orders, but it is not the priority in this scenario. The nurse should first assess the patient's pain and provide appropriate pain relief, as pain can affect the vital signs and the patient's well-being. The nurse should also document the patient's pain assessment and intervention in the medical record, as this can facilitate the continuity of care and evaluation of outcomes.