Which of the following describes status epilepticus? (Select all that apply.)

Choice A rationale

Dementia is a neurodegenerative disorder characterized by a progressive and irreversible decline in cognitive function, including memory, thinking, and reasoning. This deterioration is due to widespread neuronal loss and brain atrophy, leading to increasing dependence over time as the disease advances.

Choice B rationale

Dementia is not characterized by a sudden onset of confusion. Instead, its onset is typically insidious, with a gradual decline in cognitive abilities over months to years. A sudden onset of confusion is more indicative of delirium, which is an acute and often reversible state.

Choice C rationale

An altered level of consciousness is not typically associated with dementia. Clients with dementia generally maintain a clear level of consciousness, although they may experience confusion, disorientation, or difficulty with attention. Altered consciousness is a hallmark feature of delirium.

Choice D rationale

While high fever or dehydration can exacerbate cognitive impairment in individuals with underlying dementia, they do not trigger the development of dementia itself. These factors are more commonly associated with delirium, which is an acute confusional state, rather than the chronic progressive nature of dementia.

Choice A rationale

Rheumatoid arthritis is a chronic autoimmune inflammatory disease that commonly affects the small joints of the hands and feet bilaterally and symmetrically. Characteristic late-stage findings include ulnar deviation of the fingers, swan-neck deformities (hyperextension of the PIP joint and flexion of the DIP joint), and boutonnière deformities (flexion of the PIP joint and hyperextension of the DIP joint) due to chronic synovial inflammation.

Choice B rationale

Osteoarthritis is a degenerative joint disease characterized by cartilage breakdown, primarily affecting weight-bearing joints but also the hands. Hand findings include Heberden's nodes (DIP joints) and Bouchard's nodes (PIP joints), which are bony enlargements. Unlike rheumatoid arthritis, osteoarthritis is typically asymmetrical and lacks significant inflammation.

Choice C rationale

Gout is a form of inflammatory arthritis caused by uric acid crystal deposition in joints. While it can affect the hands, it most commonly presents as acute, severe pain, swelling, and redness in a single joint, often the great toe. Chronic gout can lead to tophi, which are visible urate deposits, but not the specific deformities seen in rheumatoid arthritis.

Choice D rationale

Paget's disease of bone is a chronic disorder characterized by abnormal bone remodeling, leading to enlarged and misshapen bones. It primarily affects the skull, spine, pelvis, and long bones of the extremities. Hand involvement is uncommon and does not typically result in the characteristic joint deformities seen in the scenario.