How to Answer Charlotte Caballero Case Questions (Complete Guide)
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Original Question
Charlotte Caballero Case Study Alternate Version Slide One Please enter your name: Slide Two Charlotte Caballero 78-years-old Lives in the dementia center Diagnosed with Alzheimer’s disease Started on donepezil Slide Three Charlotte Caballero Placed in assisted living Recently hospitalized Her cognitive impairment got much worse Slide Four Her primary care physician completed the initial exam four days ago. You are asked to see her at the request of the family, who does not understand why she could not return to assisted living. Slide Five You review the physician’s note, and he believes her AD has progressed to the moderate stage and is considering adding Namenda to donepezil therapy. Slide Six The nursing staff report she appears to be confused but is pleasant and cooperative and has improved since her admission. Slide Seven Physical Exam Alert Disoriented MMSE is 24/30 Adequate tugor Full muscle strength Normal vital signs Slide Eight 1. What is the differential diagnosis? Slide Nine 1. What is the differential diagnosis? Your Response: Suggested Response: Dementia with superimposed delirium secondary to acute illness. Slide Ten 2. Do you believe that adding Namenda to her medication at this time is advised? : Slide Eleven 2. Do you believe that adding Namenda to her medication at this time is advised? Your Response: Suggested Response: Since her cognitive decline was rather abrupt, coincided with an acute illness, and appears to be resolving, it may not be advised at this time. It would be appropriate to have a discussion with the physician. Slide Twelve 3. If she does have a resolving delirium, what non-pharmacological approaches would you suggest to the nursing staff and family? Your Response: Suggested Response Assure adequate nutrition and hydration Encourage her mobility Correct for vision/hearing Address safety issues Assure adequate sleep Assure adequate pain management Reorient/redirect as appropriate Slide Thirteen 4. What is her prospect of returning to assisted living ?: Slide Fourteen 4. What is her prospect of returning to assisted living? Your Response: Suggested Response: With resolving delirium, it is good as long as aggressive nursing interventions are taken to prevent premature decline or complications. Have a discussion with the assisted living staff and with the family.
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