An 83-Year-Old Resident of a Long-Term Care Facility Has Dementia

Multiple Choice

An 83-year-old resident of a long-term care facility has dementia.She is usually able to feed herself and perform basic ADLs with minimal assistance.She is continent of bowel and bladder,but needs assistance with toileting.The nurse aide who routinely cares for her reports to the nurse that the resident has had three episodes of urinary incontinence and has a decreased appetite.Her daughter reports that her mother seems "different" and "a bit more confused." You speak with the physician who orders a complete blood count and serum electrolytes and states "Call me if any of the labs are abnormal." The lab tests are all within normal limits.The nurse should:

A) attribute the changes in the resident's functioning to advancing dementia.The lab values are OK,so nothing acute is happening.
B) speak with the physician and suggest that the resident be placed on broad-spectrum antibiotics to prevent infections.
C) speak with the physician because,although the laboratory values are within normal limits,the changes in function (decreased appetite,change in mental status,and incontinence) may be subtle signs of illness.
D) change the plan of care to include bladder training and implement a 24-hour calorie count.