Which of the following statements by the caregiver of a client newly diagnosed with dementia requires further intervention by the nurse?

Choice A reason: Monitoring vital signs is critical in withdrawal delirium, as it is a medical emergency involving autonomic hyperactivity from alcohol or drug cessation. Dehydration and electrolyte imbalances elevate heart rate and blood pressure, risking seizures or cardiovascular collapse. Regular monitoring detects instability early, guiding fluid replacement and medication to stabilize cerebral and systemic function.

Choice B reason: Keeping the room dark may reduce sensory overload in withdrawal delirium, but it does not address physiologic instability like dehydration or autonomic hyperactivity. Darkness may calm agitation but risks disorientation in a confused patient, as visual cues aid reality testing. This choice is less critical than monitoring vital signs for ensuring systemic stability.

Choice C reason: Withholding oral fluids is contraindicated in withdrawal delirium, as dehydration exacerbates symptoms like confusion and autonomic instability. Fluid loss from sweating or vomiting, common in withdrawal, disrupts electrolyte balance and cerebral perfusion. Providing fluids corrects hypovolemia, making this choice scientifically inappropriate for maintaining physiologic stability in this critical condition.

Choice D reason: Applying ice to the tongue may reduce swelling from trauma, but it does not address the systemic instability of withdrawal delirium, such as dehydration or autonomic hyperactivity. Tongue swelling is a secondary issue compared to life-threatening risks like seizures or arrhythmias, which require monitoring vital signs and fluid management for stabilization.

Choice A reason: Aricept (donepezil) is a cholinesterase inhibitor that increases acetylcholine levels in the brain, temporarily improving cognitive symptoms in Alzheimer’s disease. It does not stop disease progression, as Alzheimer’s involves progressive neuronal loss due to amyloid plaques and tau tangles. This statement is scientifically inaccurate, as no medication halts Alzheimer’s neurodegenerative process.

Choice B reason: Taking Aricept on an empty stomach is not required, as it can be taken with or without food. Its absorption is not significantly affected by food, as it is metabolized hepatically via CYP2D6 and CYP3A4. This statement is incorrect, as it misrepresents the administration guidelines, potentially causing unnecessary restrictions for the patient.

Choice C reason: While Aricept may improve concentration by enhancing cholinergic activity in Alzheimer’s, this statement focuses on expectation rather than understanding its therapeutic role. It does not address the drug’s primary effect of temporarily slowing cognitive decline. Concentration improvement is a secondary benefit, not the primary mechanism, making this less precise scientifically.

Choice D reason: Aricept temporarily slows Alzheimer’s disease progression by inhibiting acetylcholinesterase, increasing acetylcholine, and supporting cognitive function in mild to moderate cases. It does not cure or stop the disease, as neuronal degeneration continues due to amyloid and tau pathology. This statement accurately reflects the drug’s mechanism and temporary symptomatic relief, aligning with clinical evidence.