Reference no: EM132847723

After his wandering episode, Mr. Wallace's condition rapidly declines. His communication skills are almost completely gone; he speaks infrequently and uses only two- or three-word sentences. He no longer recognizes Ms. Wallace, cannot perform ADLs, and is indifferent to food. His tendency toward wandering and aggression has disappeared. In fact, he rarely leaves his room. For his safety and to allow for provision of the care he needs, Mr. Wallace is admitted to an extended care facility that specializes in treating patients with Alzheimer disease.

• You are the nurse assigned to care for Mr. Wallace. As part of his daily assessment, you obtain his vital signs, which include temperature 99.8°F oral; pulse 92 bpm; respirations 32/min; and blood pressure 108/74 mmHg. Auscultation of Mr. Wallace's lungs reveals faint bibasilar crackles. On reviewing his chart, you note that he has experienced a 5% weight loss since the previous month. You notify the attending physician about Mr. Wallace's vital signs, breath sounds, and weight loss. The physician orders a chest x-ray and complete blood count (CBC).

Discussion 1: What is the significance of Mr. Wallace's vital signs and breath sounds?

Discussion 2: What effect might Mr. Wallace's weight loss have on his cognitive condition?

Discussion 3: What important pieces of information might be gleaned from tracking Mr. Wallace's food intake and weight?

Discussion 4: What is the priority nursing diagnosis for Mr. Wallace at this time?

Discussion 5: What independent interventions can you perform to optimize Mr. Wallace's respiratory status? What positive effects might these have on other aspects of his health?

Discussion 6: Refer to the exemplar on Alzheimer disease in this module: Would Mr. Wallace's condition improve with the addition of a cholinesterase inhibitor to his treatment regimen? Why or why not?