Nursing diagnosis – IMPAIRED MEMORY

IMPAIRED  MEMORY

DEFINITION

Inability to remember or recall bits of information or behavioral

skills

DEFINING CHARACTERISTICS

• Inability to determine whether a behavior was performed

• Inability to learn new skills or information or to perform

previously learned skills

• Inability to recall factual information and recent or past events

• Incidences of forgetting, including forgetting to perform a behavior

at a scheduled time

RELATED FACTORS

• Anemia

• Fluid and electrolyte

• Decreased cardiac output

imbalance

• Excessive environmental

• Hypoxia

disturbances

• Neurological disturbances

ASSESSMENT FOCUS    (Refer  to  comprehensive  assessment  parameters.)

• Cardiac function

• Neurocognition

• Emotional

• Self-care

• Fluids and electrolytes

EXPECTED OUTCOMES

The patient/family will

• Express feelings about memory impairment.

• Acknowledge need to take measures to cope with memory

impairment.

• Identify coping skills to deal with memory impairment.

• State specific plans to modify lifestyle.

• Establish realistic goals to deal with further memory loss.

SUGGESTED NOC OUTCOMES

Cognition; Cognitive Orientation; Concentration; Memory; Neuro-

logical Status: Consciousness

INTERVENTIONS AND RATIONALES

Determine:  Observe patient’s thought processes during every shift.

Document and report any changes. Changes may indicate progressive

improvement or a decline in patient’s underlying condition.

Perform:  Implement appropriate safety measures to protect patient

from injury. He or she may be unable to provide for his or her own

safety needs.

Call patient by name and tell him or her your name. Provide

background information (place, time, and date) frequently through-

out the day to provide reality orientation. Use a reality orientation

board to visually reinforce reality orientation.

Spend sufficient time with patient to allow her to become comfort-

able discussing memory loss and establish a trusting relationship.

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Be clear, concise, and direct in establishing goals to promote max-

imal use of patient’s remaining cognitive skills. Offer short, simple

explanations to patient each time you carry out any medical or

nursing procedure to avoid confusion.

Label patient’s personal possessions and photos, keeping them in

the same place as much as possible, to reduce confusion and create

a secure environment.

Inform:  Inform patient that you are aware of his or her memory loss

and that you will help him or her cope with his or her condition to

bring the issue into the open and help patient understand that your

goal is to help him or her.

Teach patient ways to cope with memory loss (e.g., using a beeper

to remind her when to eat or take medications; using a pillbox

organized by days of the week; keeping lists in notebooks or a

pocket calendar; having family members or friends remind her of

important tasks). Reminders help limit the amount of information

patient must maintain in her memory.

Help patient and family members establish goals for coping with

memory loss. Discuss with family members the need to maintain the

least restrictive environment possible. Instruct them on how to main-

tain a safe home environment for patient. This helps ensure that

patient’s needs are met and promotes his or her independence.

Demonstrate reorientation techniques to family members and pro-

vide time for supervised return demonstrations to prepare them to

cope with patient with memory impairment.

Attend:  Encourage patient to develop a consistent routine for

performing activities of daily living to enhance his self-esteem and

increase his self-awareness and awareness of his environment.

Encourage patient to interact with others to increase social

involvement, which may decline with memory loss.

Encourage patient to express the feelings associated with impaired

memory to reduce the impact of memory impairment on patient’s

self-image and lessen anxiety.

Manage:  Help family members identify appropriate community sup-

port groups, mental health services, and social service agencies to

assist in coping with the effects of patient’s illness or injury.

SUGGESTED NIC INTERVENTIONS

Anxiety Reduction; Calming Technique; Cerebral Perfusion Promo-

tion; Dementia Management; Fluid and Electrolyte Management;

Memory Training; Neurologic Monitoring; Reality Orientation

Reference

Parahoo, K., et al. (2006, June). Expert nurses’ use of implicit memory in the

care of patients with Alzheimer’s disease. Journal of Advanced Nursing,
54(5), 563–571.

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