An 82-year-old widow with Alzheimer's disease lives with her daughter's family,which owns a catering business.During the week,the patient attends a day care center for patients with dementia.During the evenings,members of the family care for the patient.One day,the nurse at the day care center notices the patient's appearance is disheveled and that she startles easily.She has a strong odor of urine,and her hair is uncombed.When the nurse escorts the patient to the bathroom,she notices bruises on her wrists and back.What most likely explains the nurse's observations?

Question

Quizplus · Accepted Answer

The assessment of physical abuse and neglect would be supported by the nurse's observation of bruises,increased fearfulness,and impaired hygiene.Although falls and other accidents can produce bruises,they are usually located on those parts of the body that are most likely to hit the floor first when falling;this would not be likely to include the back or the wrists.Wrist bruising often suggests that a patient has been gripped hard about the wrist during abuse or restraint.Delirium would contribute to accidents and impaired hygiene,but the pattern of bruises would be different than noted here.

An 82-Year-Old Widow with Alzheimer's Disease Lives with Her Daughter's