An 89-year-old female patient who has been admitted to the medical unit with new-onset angina also has a diagnosis of Alzheimer’s disease. The patient’s husband reports to you that he rarely gets a good night’s sleep because he needs to make sure his wife does not wander during the night. He insists on checking each of the medications you give her to be sure they are the same as the ones she takes at home. Based on this information, which nursing diagnosis is most appropriate for this patient?
A. Decreased Cardiac Output related to poor myocardial contractility
B. Caregiver Role Strain related to continuous need for providing care
C. Ineffective Therapeutic Regimen Management related to poor patient memory
D. Risk for Falls related to patient wandering behavior during the night
Correct Answer: B. Caregiver Role Strain related to continuous need for providing care
The husband’s statement about lack of sleep and anxiety over whether the patient is receiving the correct medications are behaviors that support this diagnosis.
Option A: There is no evidence that the patient’s cardiac output is decreased. Alzheimer?s disease and HF often occur together and thus increase the cost of care and health resource utilization; this highlights the need to investigate the relationship between these two conditions. Impaired cognition in HF patients leads to significantly more frequent hospital readmissions and increases mortality rates.
Option C: Ineffective Therapeutic Regimen Management is not a priority as based on the statement.
Option D: Risk for falls is not the priority at this time. Falls are a leading cause of broken hips and other serious injuries in the elderly, and those with Alzheimer’s are at particularly high risk of falling. Problems with vision, perception, and balance increase as Alzheimer’s advances, making the risk of a fall more likely.