drashishmahajan
Forum Senior
Topics: 6
Posts: 92
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. A 75-year-old man with a 3-year history of
progressive cognitive
impairment due to dementia, Alzheimer's type, has had
nocturnal
disorientation for 2 weeks. He lives at home with his
wife. He is otherwise
healthy and takes no medications. Physical
examination shows normal
findings. He is disoriented to time and place, has
poor short-term
memory, is unable to do simple arithmetic, and has a
poor understanding of
general information. Which of the following is the
most appropriate
initial step in management?
A
) Increase in home nighttime lighting
B
) Prescription for chloral hydrate
C
) Prescription for diazepam
D
) Prescription for haloperidol
E
) Use of nighttime mechanical restraints
explain too
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| Chrales
Forum Newbie
Topics: 2
Posts: 30
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Answer A is correct: Alzheimer patients have a worsening of their dementia in the evening ("sundowning"). So they might have difficulties in orientation during the night (even in their own home). Light may help them to get a better orientation.
If this fails you may try E (mechanical restranits). The other answers are non-sense.
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| Geroo
Forum Guru
Topics: 114
Posts: 799
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I think A too
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| robin082006
Forum Hero
Topics: 471
Posts: 5,123
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A
) Increase in home nighttime lighting
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The Key to Succeed is Patience.
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| huyniid
Forum Elite
Topics: 9
Posts: 199
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A
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| thuc
Forum Newbie
Topics: 5
Posts: 9
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what about this article
http://www.gerimed.co.uk/sites/gerimed/downloads/...
according to this article, it says that minimal exposure to bright light decreases nocturnal confusion. it also lists that haloperidol is an effective pharmacological agent.
is bright light the same as night-time lighting?
then should the answer be D?
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