In a long-term care facility, a nurse is having a discussion with the nurse aides about ways to deal with dementia clients who are uncooperative with mouth care. Appropriate methods to use include which of the following?

Having another nurse aide assist in holding the client’s mouth open with a tongue depressor

Involving the client in the process of oral hygiene, such as using the hand-over-hand technique to brush the client's teeth

Speaking to the client sternly and instructing the client to open their mouth and cooperate immediately

Quickly performing oral hygiene without explanation since the client is uncooperative

Answer and Explanation

The Correct Answer is B

Choice A reason: This method is not appropriate because it can cause physical and psychological harm to the client. It can injure the client's mouth, trigger a gag reflex, or cause choking. It can also make the client feel violated, frightened, or angry. This can worsen the client's behavior and damage the trust between the client and the caregiver.

Choice B reason: This method is appropriate because it can help the client maintain their dignity, autonomy, and sense of control. It can also stimulate the client's cognitive and motor skills, and encourage the client to participate in their own care. This can improve the client's mood and behavior, and foster a positive relationship between the client and the caregiver.

Choice C reason: This method is not appropriate because it can cause emotional and psychological harm to the client. It can make the client feel disrespected, humiliated, or threatened. It can also increase the client's anxiety, agitation, or resistance. This can worsen the client's behavior and damage the trust between the client and the caregiver.

Choice D reason: This method is not appropriate because it can cause physical and psychological harm to the client. It can injure the client's mouth, trigger a gag reflex, or cause choking. It can also make the client feel ignored, neglected, or devalued. This can worsen the client's behavior and damage the trust between the client and the caregiver.

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Correct Answer is C

Explanation

Choice A reason: Changing facial expression is not a likely action to be observed during the assessment, as PD causes reduced facial expression or mask-like face. The client may have difficulty blinking, smiling, or showing emotions.

Choice B reason: Frequent movement is not a likely action to be observed during the assessment, as PD causes slowed movement or bradykinesia. The client may have difficulty initiating, continuing, or completing movements.

Choice C reason: Resting hand tremors is a likely action to be observed during the assessment, as PD causes rhythmic shaking of the hands, fingers, or other body parts. The tremors usually occur when the affected limb is at rest and may decrease when the client is performing tasks.

Choice D reason: Fast movements is not a likely action to be observed during the assessment, as PD causes impaired movement or dyskinesia. The client may have involuntary, jerky, or twisting movements that are often unpredictable and uncontrollable.

Choice E reason: None of the above is not the correct answer, as there is one choice that is a likely action to be observed during the assessment.

A. Use of a commode close by to where the client spends most of his time B. Development of a toileting schedule C. Use of an external catheter D. Bladder diary to be completed by the client's wife

Correct Answer is ["A","B"]

Explanation

Choice A reason: Use of a commode close by to where the client spends most of his time can reduce the distance and time required for the client to reach the toilet, and thus prevent accidents and embarrassment. It can also promote the client's independence and dignity.

Choice B reason: Development of a toileting schedule can help the client to establish a routine and habit of voiding at regular intervals, and thus prevent the bladder from becoming too full or overactive. It can also reduce the risk of urinary tract infections and skin breakdown.

Choice C reason: Use of an external catheter is not recommended for older adults with dementia, as it can cause irritation, infection, and obstruction of the urinary tract. It can also increase the client's confusion and agitation, and interfere with his mobility and comfort.

Choice D reason: Bladder diary to be completed by the client's wife is not a direct intervention to manage the incontinence, but rather a tool to assess the pattern and severity of the problem. It can help the nurse to identify the possible causes and triggers of the incontinence, and to evaluate the effectiveness of the interventions. However, it may not be feasible or reliable for the client's wife to complete the diary, as she may have other responsibilities or difficulties in observing and recording the client's urinary habits.

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In a long-term care facility, a nurse is having a discussion with the nurse aides about ways to deal with dementia clients who are uncooperative with mouth care. Appropriate methods to use include which of the following?

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Explanation

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