Dementia/Physical Aggression
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Ron Jackson, 87 years old
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Primary Concept
COGNITION
Interrelated Concepts (In order of emphasis)
• Psychosis
ed d
• Mood and Affect
ar stu
• Coping
• Clinical Judgment
NCLEX Client Need Categories Percentage of Items from Each Covered in
is
Category/Subcategory Case Study
Th
Safe and Effective Care Environment
• Management of Care 17-23% ✓
• Safety and Infection Control 9-15%
Health Promotion and Maintenance 6-12% ✓
sh
Psychosocial Integrity 6-12% ✓
Physiological Integrity
• Basic Care and Comfort 6-12% ✓
• Pharmacological and Parenteral Therapies 12-18% ✓
• Reduction of Risk Potential 9-15% ✓
• Physiological Adaptation 11-17% ✓
Copyright © 2019 Keith Rischer, d/b/a KeithRN.com. All Rights reserved
This study source was downloaded by 100000829957125 from CourseHero.com on 10-19-2021 09:45:10 GMT -05:00
https://www.coursehero.com/file/92046169/case-study-3pdf/
, Part I: Recognizing RELEVANT Clinical Data
History of Present Problem:
Ron Jackson is an 87-year-old Caucasian male with a medical history of hypertension and Alzheimer's disease who was
brought to the emergency department (ED) by paramedics for evaluation of hallucinations, increased agitation, and
aggressive behavior toward Shirley, his elderly wife. His daughter was visiting and witnessed Ron becoming angry for no
apparent reason, telling Shirley she had to leave the house. He then pushed her, causing her to fall to the ground.
Ron has become progressively more agitated the past year and was started on quetiapine. Shirley confirms that Ron
has been more verbally abusive the past week, believing that she divorced him and that she needs to get out of the house,
but no physical aggression took place until today. Ron currently complains of a headache and insists that he got this
because “the Koreans beat me up real good in the ambulance!”
Personal/Social History:
Ron lives at home with Shirley, his wife of 62 years and has three children. Ron is a Korean War veteran who saw active
duty and is a retired salesman. Because his wife has been struggling to care for him, his family is in the process of making
arrangements for him to reside at a local memory care unit.
What data from the histories are RELEVANT and must be interpreted as clinically significant by the nurse?
(Reduction of Risk Potential)
m
RELEVANT Data from Present Problem: Clinical Significance:
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RELEVANT Data from Social History: Clinical Significance:
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1. Identify the relationship between the PMH and home medications. Which medication treats which condition?
Draw a line to connect the PMH to the correct medication.
is
Past Medical History (PMH): Home Meds:
Hyperlipidemia Donepezil 10 mg PO at HS
Th
Hypertension Aspirin 325 mg PO daily
Alzheimer's disease Memantine 10 mg PO BID
Agitation/Delusions Simvastatin 20 mg PO HS
sh
Triamterene-HCTZ 75-50 mg PO daily
Quetiapine 50 mg PO BID
2. Is there a relationship between any problem in his past medical history and the present problem? If so,
describe.
Copyright © 2019 Keith Rischer, d/b/a KeithRN.com. All Rights reserved
This study source was downloaded by 100000829957125 from CourseHero.com on 10-19-2021 09:45:10 GMT -05:00
https://www.coursehero.com/file/92046169/case-study-3pdf/
m
er as
co
eH w
o.
rs e
ou urc
o
Ron Jackson, 87 years old
aC s
vi y re
Primary Concept
COGNITION
Interrelated Concepts (In order of emphasis)
• Psychosis
ed d
• Mood and Affect
ar stu
• Coping
• Clinical Judgment
NCLEX Client Need Categories Percentage of Items from Each Covered in
is
Category/Subcategory Case Study
Th
Safe and Effective Care Environment
• Management of Care 17-23% ✓
• Safety and Infection Control 9-15%
Health Promotion and Maintenance 6-12% ✓
sh
Psychosocial Integrity 6-12% ✓
Physiological Integrity
• Basic Care and Comfort 6-12% ✓
• Pharmacological and Parenteral Therapies 12-18% ✓
• Reduction of Risk Potential 9-15% ✓
• Physiological Adaptation 11-17% ✓
Copyright © 2019 Keith Rischer, d/b/a KeithRN.com. All Rights reserved
This study source was downloaded by 100000829957125 from CourseHero.com on 10-19-2021 09:45:10 GMT -05:00
https://www.coursehero.com/file/92046169/case-study-3pdf/
, Part I: Recognizing RELEVANT Clinical Data
History of Present Problem:
Ron Jackson is an 87-year-old Caucasian male with a medical history of hypertension and Alzheimer's disease who was
brought to the emergency department (ED) by paramedics for evaluation of hallucinations, increased agitation, and
aggressive behavior toward Shirley, his elderly wife. His daughter was visiting and witnessed Ron becoming angry for no
apparent reason, telling Shirley she had to leave the house. He then pushed her, causing her to fall to the ground.
Ron has become progressively more agitated the past year and was started on quetiapine. Shirley confirms that Ron
has been more verbally abusive the past week, believing that she divorced him and that she needs to get out of the house,
but no physical aggression took place until today. Ron currently complains of a headache and insists that he got this
because “the Koreans beat me up real good in the ambulance!”
Personal/Social History:
Ron lives at home with Shirley, his wife of 62 years and has three children. Ron is a Korean War veteran who saw active
duty and is a retired salesman. Because his wife has been struggling to care for him, his family is in the process of making
arrangements for him to reside at a local memory care unit.
What data from the histories are RELEVANT and must be interpreted as clinically significant by the nurse?
(Reduction of Risk Potential)
m
RELEVANT Data from Present Problem: Clinical Significance:
er as
co
eH w
o.
rs e
ou urc
o
RELEVANT Data from Social History: Clinical Significance:
aC s
vi y re
ed d
ar stu
1. Identify the relationship between the PMH and home medications. Which medication treats which condition?
Draw a line to connect the PMH to the correct medication.
is
Past Medical History (PMH): Home Meds:
Hyperlipidemia Donepezil 10 mg PO at HS
Th
Hypertension Aspirin 325 mg PO daily
Alzheimer's disease Memantine 10 mg PO BID
Agitation/Delusions Simvastatin 20 mg PO HS
sh
Triamterene-HCTZ 75-50 mg PO daily
Quetiapine 50 mg PO BID
2. Is there a relationship between any problem in his past medical history and the present problem? If so,
describe.
Copyright © 2019 Keith Rischer, d/b/a KeithRN.com. All Rights reserved
This study source was downloaded by 100000829957125 from CourseHero.com on 10-19-2021 09:45:10 GMT -05:00
https://www.coursehero.com/file/92046169/case-study-3pdf/
