Reference no: EM134013441

Question

An 89-year-old female with Alzheimer's dementia residing in a long-term care facility becomes agitated when the nurse approaches her with medication. She starts screaming and pushes away the nurse, saying "They are trying to kill me!" and similar sentences. The behavior came on rather abruptly, as she was described as calm during breakfast and lunch. She is inconsolable by any of the staff and starts crying in addition to the screaming that has been occurring since the nurse approached her.

Upon review of her chart, it is noted that in addition to Alzheimer's dementia, she suffers from hypertension, type II diabetes, and GERD. She had a kidney stone about 15 years ago, and was noted to have a urinary tract infection when her urine was tested at her annual physical examination about 2 weeks ago. This was subsequently treated with an antibiotic for 5 days.

She is described by the staff as typically mild mannered and quiet. She tends to keep to herself and not associate with other residents very often. There have been no recent changes to her medications. She was recently moved to a new room when her roommate died.

1. What additional information do you need regarding this patient?

2. How would you assess this patient?

3. What are your thoughts on differential diagnoses for this patient?

4. How would you manage the patient at this time?