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Difficulty: MediumAging Process

Staff at an adult day care center report that an 81-year-old participant, who is typically sociable and continent, is experiencing new-onset urinary incontinence and wandering aimlessly. The participant appears restless and repeatedly attempts to leave the building. Which of the following interventions should the practical nurse implement? (Select all that apply.)

  1. Check the client's vital signs and oxygen saturation levels.Answer
  2. Obtain a urine specimen for laboratory analysis as prescribed.Answer
  3. Relocate the client to a calm, low-stimulation environment with direct supervision.Answer
  4. D
    Document the sudden wandering and restlessness as expected age-related cognitive decline.
  5. E
    Place the client in a bedside chair with a secured lap belt to prevent elopement.
  6. F
    Administer an as-needed (PRN) antipsychotic medication to quickly manage the restless behavior.

Answer

The correct interventions are to check the client's vital signs, obtain a prescribed urine specimen, and relocate the client to a calm, supervised environment.
In the older adult population, acute infections (especially urinary tract infections) often present atypically with sudden confusion, incontinence, and behavioral changes collectively known as delirium. The practical nurse must prioritize identifying the underlying physiological cause by checking vital signs and obtaining lab specimens, while maintaining the client's safety through non-restrictive measures like a calm environment and direct supervision.

Step-by-Step Solution

1
Recognize atypical disease presentation in the older adult.
Identified that sudden onset of incontinence, restlessness, and wandering are hallmark signs of delirium rather than normal aging.
Older adults frequently exhibit acute confusion as the primary symptom of physiological stressors, such as infections.
2
Prioritize physiological assessment to find the reversible cause.
Selected checking vital signs, oxygen saturation, and obtaining a urine specimen.
Gathering objective data helps identify if a urinary tract infection, hypoxia, or other physiological disruption is causing the sudden behavioral shift.
3
Implement safety measures using the least restrictive interventions.
Selected relocating the client to a calm, low-stimulation environment with direct supervision.
Maintaining client safety is critical during an episode of delirium, but it must be achieved without resorting to physical or chemical restraints.

Key Concept

Atypical Presentation of Illness and Delirium in Older Adults
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Topics

Aging Process

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