Question

Bertha is an 86-year-old resident of the dementia unit in a nursing home facility. Her speech consists of irrational sentence fragments unrelated to any conversation directed to her. Her usual activity is ambulating down the corridor with her walker, going in and out of rooms at random. For the past 2 days, Bertha has resisted getting out of bed. She has been less responsive with few verbal utterances. Today the nurse finds her crying and restless. She has developed a fever and is shaking. The nurse notes a strong odor to the urine in the brief Bertha has been wearing. The nurse realizes that Bertha is unable to describe pain or the location of any discomfort.

1. What might the changes in Bertha’s behavior indicate?

2. How might her behavior be related to other symptoms?

3. What action should the nurse take?

Answer 1

1) I think signs and symptoms indicate the patient having severe UTI. UTI can cause sudden confusion, in especially people with old age and demetia. If the patient has sudden unexpected changes in the behavior, like restless, bad smell in the urine , fever and shaking , agitation , withdrawal, increased confusions are May be because of UTI.

2) this behavior of patient showing, she might be going in the state of delirium. UTI in someone with dementia can cause a significant and distressing change in behavior, commonly referred to as acute confusional state or delirium.

3) first clean the patient if she bed wet

check the vitals especially temperature

Orient the client, frequently orient client to reality and surrounding

encourage caregivers about patient orientation

enforce with positive feedback

explain simply

discourage suspiciousness of others

avoid cultivation of false ideas

observe client closely

remind the patient to use the bathroom just before his usual time

try setting a regular schedule for toilet use

choose clothing that is easy to remove and clean

Encourage the patient to voiding 2-3 hourly

provide fluids to promote renal blood flow

administer antibiotic for UTI as prescribed by doctor order

maintain personal hygiene

avoid risk of other infections