Reference no: EM133912752

Question

Mr. Wilson is a 78-year-old widower, seen today by an Advanced Practice Registered Nurse (APRN), the healthcare provider (HCP) at the community ambulatory care clinic. He is accompanied by his daughter, who is concerned about his increasing forgetfulness, anxiety, and wandering in the house at night. He has a history of coronary artery disease, hypertension, and NIDDM. He was diagnosed with Mild Neurocognitive disorder due to Alzheimer's disease one year ago.

Mr. Wilson's daughter moved into his home 6 months ago to help care for him. She works full time as an engineer for the city. Mr. Wilson has managed his ADLs and medication administration until this past month. His daughter purchased a pill organizer to help him remember to take his medication, and she leaves him prepared lunches when she goes to work, which he forgets to eat.

The nurse administers the Mini-Cog assessment tool. Mr. Wilson has poor short-term memory, is easily distracted, and is orientated to person and place only. Mr. Wilson's vital signs are:

BP 90/60 mmHg
T 100° F (38° C)
HR 92 beats/min
R 28 breaths/min
blood glucose 30

Onset and Diagnosis:

Mr. Wilson is upset about visiting the NP and he tells the office RN that there is nothing wrong with him. The RN notes that Mr. Wilson's face is flushed, and he is wringing his hands. He states that he does not know why he is at the clinic. He stands by the door, shuffling his feet.