A client with Alzheimer's disease is found on the floor after a fall. The following day, she grimaces and cries out in pain. What is the most appropriate nursing action?

A client with Alzheimer's disease is found on the floor after a fall. The following day, she grimaces and cries out in pain. What is the most appropriate nursing action?

• A. Contact the facility physician.
• B. Call an ambulance to transport Ms. Abetiu to the hospital.
• C. Ask Ms. Abetiu if she is experiencing any pain.
• D. Contact Ms. Abetiu's family to report the incident and present manifestations.

Answer: (A)

Pain in a client with Alzheimer's may not be reported reliably, so new signs of distress after a fall require medical evaluation. The most appropriate action is to contact the facility physician to assess for possible injury and to obtain orders for further action, such as imaging, analgesia, or hospital evaluation. The physician can determine the necessity and urgency of tests, changes in care, or transfer. While assessing pain directly and notifying family are important parts of care, they don’t substitute for professional evaluation and orders when new pain emerges after a fall.

Pain in a client with Alzheimer's may not be reported reliably, so new signs of distress after a fall require medical evaluation. The most appropriate action is to contact the facility physician to assess for possible injury and to obtain orders for further action, such as imaging, analgesia, or hospital evaluation. The physician can determine the necessity and urgency of tests, changes in care, or transfer. While assessing pain directly and notifying family are important parts of care, they don’t substitute for professional evaluation and orders when new pain emerges after a fall.