Nursing psych quiz
1. Patients positively diagnosed with dementia are commonly easily agitated and this behavioral symptom poses as an additional problem for the patient. In addition, nurses, family members and other caregivers may also experience more difficulty in caring for the patient. An effective plan of care to reduce agitation in a patient with dementia is to lessen and possibly prevent any factors that may cause discomfort in the patient. A study conducted by Pelletier and Landreville (2007) involved a correlational investigation of discomfort in combination with agitation among 49 residents of an elderly facility which housed patients positively diagnosed with dementia. Their report described that discomfort causes agitation 80% of the time. Discomfort can be gauged by the patient’s ability to complete his daily activities, wherein a patient that finds himself unable to perform a particular activity that he used to complete everyday. In addition, patients with dementia are commonly observed to wander and unfortunately fall and hurt themselves. It is therefore advisable that the plan of care for patients with dementia include security measures that would make sure that the patient will not be left unattended in order to avoid accidental falls and prevent them from experiencing getting lost when they wander.
Another component that can be included in the plan of care to reduce agitation in a patient with dementia is the administration of antipsychotic drugs such as risperidone or aripiprazole. Clinical trials have shown that patients with dementia significantly improved with regards to their agitation symptoms associated with their mental conditions (Jeste et al., 2008). In addition, it will be beneficial if a nurse would attend to majority of the request of the patient, in order for the patient to feel that he is totally being cared for and given sufficient attention and interaction during his care at the healthcare facility.
2. The signs of impaired nursing practice include a worsening of the function of the healthcare personnel, including the increased frequency in calling in sick at the clinic. It has been estimated that approximately 1 in 10 nurses is struggling with an addiction or is currently in the process of recovering from an addiction. Aside from these simple signs of impaired nursing practice, there may also be two major categories to determine whether a nurse might probably be impaired. Physical symptoms that are strongly associated with impaired nursing practice include physical observation of tremors in the hands or fingers. In addition, an impaired nurse may also slur in her speech as well as present with dilated pupils. The eyes of an impaired nurse are also often watery and she goes around the clinic with a shaky gait. An impaired nurse often loses a significant amount of weight and her manner of grooming herself may suddenly change to a less tidy condition. Among the behavioural symptoms of impaired nursing practice are sudden mood swings and random laughing bouts at work. In addition, an impaired nurse may also feel depressed, with intermittent manic episodes. The impaired nurse may also express difficulty in concentrating during working hours. At an extreme, an impaired nurse may experience blackouts which may negatively affect her functioning at the clinic. This individual may also suffer from a number of accidents that could have been avoided if she were physically moving in a proper gait. An impaired nurse may also express problems with her partner and may possibly end a relationship for some interaction problem with her partner. She may also be experiencing an insufficiency in sleep and thus come in at work with frequent yawning and watery eyes. The lack of rest at night may jeopardize the work she has to complete during the day and the patients and physicians may also find her mistakes in patient care to be unreasonable and avoidable. Random checks for drug use through urine sampling may determine whether a nurse is impaired and thus this will prevent further damage in their performance at the hospital.
Jeste DV, Blazer D, Casey D, Meeks T, Salzman C, Schneider L, Tariot P and Yaffe K (2008): ACNP white paper: Update on use of antipsychotic drugs in elderly persons with dementia. Neuropsychopharmacology. 33: 957–970.
Pelletier IC and Landreville P (2007): Discomfort and agitation in older adults with dementia. BMC Geriatrics 7:27-34.