Impaired Memory Nursing Care Plans Diagnosis and Interventions
Impaired Memory NCLEX Review and Nursing Care Plans
Memory loss (amnesia) is defined as one’s inability to recall and retrieve information. Patients are unable to recall recent events, one or more past recollections, or both.
The memory loss could be temporary and eventually disappear (transient). It may not go away, or it may worsen over time, depending on the source. Such memory impairment can interfere with daily tasks in severe cases.
Types of Impaired Memory
Short-term and long-term memory work differently, and each can be affected by different factors. While forgetting things is a normal part of growing older, some memory problems may suggest a more serious problem. Anyone who believes their memory loss is the result of something else should see a doctor.
- Short-term Memory Loss. Short-term memory (STM), also known as short-term storage, primary, or active memory, refers to various memory systems that are involved in the temporary storing of bits of information (memory chunks) (usually up to 30 seconds). STM functions as a “scratchpad” for recalling a small number of data from the sensory register that are ready to be processed by attention and recognition. STM is concerned with wide knowledge of facts, rules, concepts, and propositions (‘generic knowledge’).
STM impairment causes the person to forget information that was recently presented to them. A person who is losing STM frequently asks the same questions, forgets where he just put something, and forgets recent events or anything he saw or read recently. Fixation amnesia refers to the loss of immediate memory. The clinical characteristics of STM impairment, on the other hand, vary depending on the underlying cause of memory loss.
- Long-term Memory Loss. The ability to recall and retrieve past memories is referred to as long-term memory. Memories of how to accomplish activities or skills (i.e., procedural memories, “knowing how”) and memories of facts, rules, concepts, and events (i.e., declarative memories, “knowing that”) are stored in the LTM. Semantic and episodic memory are included in declarative memory. LTM is concerned with personal and experienced events and their settings (‘personal recollection’).
Signs and Symptoms of Impaired Memory
One of the first indicators of dementia is memory loss that causes a disruption in one’s life. Other early warning signs could include:
- Repeatedly asking the same questions
- When speaking, forgetting common words
- Making grammatical errors, such as stating “bed” instead of “table.”
- Completing routine chores, such as following a recipe, takes longer.
- Putting items in inconvenient locations, such as a wallet in a kitchen drawer
- Getting lost when walking or driving in a known area
- Experiencing unexpected shifts in mood or conduct
The signs and symptoms of impaired memory may also depend on the type of memory loss:
- Short-term Memory Loss. Short-term memory loss is defined as forgetting recent events. This can result in:
- constantly asking the same questions
- forgetting the placement of an object that was recently put in that location
- forgetting what happened recently
- forgetting anything that was recently saw or read
- Long-term Memory Loss. The most common symptom of long-term memory loss is forgetting events from one’s past that may have been important or significant, such as the name of one’s high school or previous address. Other manifestations may include:
- conflating words, for as referring to a table as a bed
- forgetting everyday words
- becoming disoriented in familiar surroundings
- common chores taking longer to complete
- Changes in mood and behavior, such as irritation
Related Factors to Impaired Memory
- Aging. Normal aging-related memory decline has little impact on one’s regular activities. For example, one might forget a person’s name now and then but remember it afterwards. Patients might lose their glasses from time to time or perhaps make lists more frequently than usual to recall appointments or tasks. Memory problems are usually controllable and have little impact on one’s ability to work, live alone, or have a social life.
- Dementia. The term “dementia” refers to a group of symptoms that include problems with memory, logic, judgment, language, and other cognitive abilities. Dementia normally develops over time, worsening a person’s ability to work, interact socially, and form relationships.
Causes of Impaired Memory
Some of the most common causes of memory loss are discussed below.
- Medications. A variety of prescription and over-the-counter drugs can cause or interfere with memories such as antihistamines, antidepressants, anti-anxiety drugs, muscle relaxants, tranquilizers, sleeping pills, and post-surgery pain medications.
- Use of alcohol, cigarettes, or drugs. Excessive alcohol consumption has long been linked to memory loss.
- Smoking impairs memory because it reduces the quantity of oxygen delivered to the brain. Studies show that smokers have a tougher problem matching names to faces than nonsmokers. Illegal drugs alter brain chemistry, making it difficult to recollect memories.
- Deprivation of sleep. Memory is affected by both the quantity and quality of sleep. Sleep deprivation or frequent awakening during the night can cause weariness, which impairs the ability to consolidate and retrieve knowledge.
- Stress and depression. Depressed people have trouble paying attention and focusing, which can impact memory. Concentration can be hampered by stress and anxiety. One’s capacity to remember can be harmed when someone is anxious, having a mind that is overstimulated or distracted. An emotional trauma can produce stress, which can lead to memory loss.
- Deficiency of nutrients. Proper brain function necessitates good nutrition, which includes high-quality proteins and lipids. Vitamin B1 and B12 deficiencies, in particular, can damage memory.
- Head trauma. A serious head injury, such as from a fall or car accident, can damage the brain and cause both short- and long-term memory loss. Memory may improve gradually over time.
- Stroke. A stroke happens when a blood vessel to the brain is blocked or a vessel leaks into the brain, cutting off the blood supply to the brain. Short-term memory loss is common after a stroke. After a stroke, a person may recall vivid childhood recollections but be unable to recall what they ate for lunch.
- Temporary global amnesia (TGA). This is a temporary lack of memory formation that normally goes away on its own and does not cause any harm. Small strokes in the hippocampus are occasionally noticed (the area of brain associated with memory formation).
- Dementia. Dementia is a term used to describe a progressive loss of memory and other parts of thought that is severe enough to interfere with daily activities. Although there are several causes of dementia, including blood vessel disease, drug or alcohol misuse, or other types of brain injury, Alzheimer’s disease is the most common and well-known. Alzheimer’s disease is marked by a progressive loss of brain cells as well as other brain abnormalities.
- Other factors. An underactive or overactive thyroid gland, illegal drug use, and brain diseases such as HIV, TB, and syphilis are all possible causes of memory loss.
Complications of Impaired Memory
Dementia can impair a variety of physiological systems, affecting one’s ability to operate. Dementia can result in:
- Nutritional deficiencies. Many persons with dementia eventually quit or restrict their meals, resulting in vitamin deficiencies. They may be unable to chew and swallow in the future.
- Pneumonia. Swallowing difficulties raise the danger of choking or aspirating food into the lungs, which can prevent breathing and lead to pneumonia.
- Inability to take care of oneself. As dementia worsens, it might make it difficult to bathe, dress, brush one’s hair or teeth, use the toilet independently, or take medications as prescribed.
- Personal security issues. For people with dementia, daily activities such as driving, cooking, walking, and living alone might pose safety concerns.
- Death. Late-stage dementia leads to coma and death, which is commonly caused by infection.
Diagnosis of Impaired Memory
An appointment with the doctor is needed if there are instances of becoming increasingly forgetful or if memory problems are interfering with one’s everyday life to establish the reason and best treatment.
- The doctor will take a medical history, perform a physical exam, including a neurologic exam, and ask mental ability questions to assess memory loss.
- Further testing may include blood and urine tests, nerve tests, and brain imaging tests such as computerized axial tomography (CAT) scans or magnetic resonance imaging, depending on the results (MRI).
- Neuropsychological testing, a battery of tests that helps pinpoint memory loss, may also be ordered.
Treatment of Impaired Memory
Treatment for memory loss is determined by the underlying cause and may be reversible in many circumstances. Medication-induced memory loss, for example, may be resolved by switching drugs.
Memory loss caused by a dietary shortage might be helped with nutritional supplements. When depression is present, treating it may be beneficial to memory. In some circumstances, such as after a stroke, treatment can help patients recall how to perform things like walk or tie their shoes. Certain people’s memory may improve over time.
Treatments for memory loss problems may also be particular. For example, medications to treat Alzheimer’s disease-related memory impairments are available, and blood pressure-lowering drugs can help lessen the chance of additional brain damage from dementia caused by high blood pressure.
Impaired Memory Nursing Diagnosis
Nursing Care Plan for Impaired Memory 1
Nursing Diagnosis: Impaired Memory related to alterations in cognition, neuronal destruction or chemical imbalance in the brain secondary to dementia as evidenced by time, place, person and condition disorientation, reduced reasoning and conceptualization abilities, inability to think clearly, calculation difficulties, memory problems, attention span decreases, easy distractibility, inability to obey simple or complex instructions, personal hygiene and attractiveness have deteriorated.
Desired Outcomes:
- The patient’s mental and psychological functions will be maintained as long as possible, and actions will be reversed when possible.
- Family members will demonstrate knowledge of required care, acceptable coping skills, and use of community resources.
- The patient will acquire optimal functional capacity with adaptations and alterations to his/her environment to compensate for limitations,
| Impaired Memory Nursing Interventions | Rationale |
| Orient the patient to the environment as needed if his/her short-term memory is not impaired. | Reality orienting treatments promote awareness of self and environment only in people with delirium or depression. Patients in the early stages of Alzheimer’s who are aware that they are losing their sense of reality may be reassured. When dementia is irreversible and the patient can no longer understand reality, it does not work. People who are unable to distinguish between reality and fiction or what they see on television may experience agitation and disorientation as a result of overstimulating television and radio shows. |
| Employ a calendar or organize a written reminder list for the patient. | Patients can benefit from written reminders to help them recall certain behaviors. |
| Exercise, guided meditation, and massage are examples of supplementary and alternative therapy. | These activities can aid in stress reduction. Stress can exacerbate memory loss. |
| Assist the customer in putting together a pharmaceutical cabinet. | A prescription box can help people remember to take their medication on time and to refill the box. |
| Assess the patient’s memory and cognition in general. | Cognitive assessment tools such as GPCOG can be used to determine the patient’s cognitive function. The assessment’s findings are used to guide treatment and follow-up evaluation. |
| Check for sensory deprivation, CNS drug use, poor nutrition, dehydration, infection, or other disease processes in the patient. | Side effects include confusion and an alteration in mental status. |
| Conduct comprehensive person-centered assessments and interim assessments on a regular basis. | Assessments should be done at least once every six months to uncover difficulties that will assist the person with dementia in living a complete life. |
Nursing Care Plan for Impaired Memory 2
Nursing Diagnosis: Impaired Memory related to hypoxemia, brain tumors, and/or generalized systemic opportunistic infection, CVA/hemorrhage, vasculitis, renal failure, severe electrolyte imbalance, and hepatic insufficiency, medication metabolism/excretion changes, hazardous elements accumulate secondary to HIV/AIDS as evidenced by distractibility, altered attention span, memory impairment, delusional thinking, disorientation, cognitive dissonance, disturbances in sleep, impaired decision-making/problem-solving abilities, inability to follow complex commands/mental tasks, and loss of impulse control.
Desired Outcome: The patient will maintain normal reality orientation and cognitive performance.
| Impaired Memory Nursing Interventions | Rationale |
| Using the right instruments, assess the patient’s mental and neurological health. | Sets a functional level at the time of admission and serves as a benchmark for future comparison. |
| Consider the negative consequences of emotional anguish. Examine for anxiety, sadness, and rage. | Reduced alertness, disorientation, withdrawal, and hypoactivity may occur, necessitating additional examination and treatment. |
| Keep track of the patient’s prescription schedule and consumption. | The cumulative effects of numerous drugs’ activities and interactions, as well as increased drug half-life and/or changed excretion rates, increase the likelihood of hazardous responses. Some medicines have negative side effects, such as haloperidol (Haldol), which can severely impair motor ability in people with AIDS dementia. |
| Examine changes in personality, stimuli response, orientation, and state of awareness; or the onset of headache, nuchal stiffness, vomiting, fever, or seizure activity. | Changes can happen for a variety of causes, including the onset or worsening of opportunistic illnesses or CNS infection. Early detection and treatment of CNS illness can help to prevent persistent cognitive impairment. |
| Maintain a pleasant atmosphere by providing adequate auditory, visual, and cognitive stimulation. | Normal external cues can aid in the maintenance of a sense of reality orientation. |
| Discuss how to keep track of activities using datebooks, lists, and other devices. | These strategies assist patients in dealing with memory issues. |
| Encourage the patient’s family and SO to socialize by providing current news and family events. | Familiar encounters might help patients preserve their sense of reality, especially if they are hallucinating. |
| Encourage the patient to participate in as many activities as possible, such as dressing and grooming everyday, visiting friends, and so on. | Can help keep the patient’s mental talents for a longer time. |
Nursing Care Plan for Impaired Memory 3
Nursing Diagnosis: Impaired Memory related to medicines for Parkinsonism, psychological causes, depression, erroneous belief system, chronic illness, misperceptions secondary to Parkinson’s Disease as evidenced by incorrect environmental interpretation, lifestyle modifications, egocentricity, distractibility, incorrect reasoning, memory problems, and inability to do out activities as before.
Desired Outcomes:
- The patient will discover elements that trigger depressive reactions and employ ways to minimize the severity and frequency of these episodes.
- The patient will adhere to the therapy regimen.
| Impaired Memory Nursing Interventions | Rationale |
| Examine the patient for depressive behaviors and circumstances that caused them and reacquaint them with reality if needed. | Depression is widespread in PD patients, but it’s unclear whether it’s a reaction to the condition or a result of biochemical abnormalities. Identify particular issues and enable for the creation of a treatment strategy. Reality orientation assists the patient in being more aware of themselves and their environment. |
| Approach the patient with a nonjudgmental approach and attentively listen to his feelings and worries. | Establishes a trustworthy relationship with the patient and allows them to address subjects that will help them cope in the best way possible. Physical slowness and the enormous effort that even little actions demand can cause PD patients to feel ashamed, apathetic, bored, and lonely. Encourage and help the patient in making every effort to complete the tasks necessary to meet their own daily needs in order to remain independent. |
| Determine the medications the patient is currently taking. | Assists in the detection of any drug usage or adverse effects that may trigger depressed symptoms. |
| Examine the patient for signs of suicidality and suicidal ideation. | Patients who are depressed and have considered suicide are serious and require immediate assistance. |
| Vital signs should be checked every 4 hours and on demand. | Antidepressants and other psychotropic drugs can cause cardiovascular and cerebrovascular problems. Psychiatric problems, mood swings, and hallucinations are possible side effects. |
Nursing Care Plan for Impaired Memory 3
Nursing Diagnosis: Impaired Memory related to chemical modifications (e.g., medications, electrolyte imbalances), support systems are insufficient, life experiences that are really stressful, possible hereditary factor, anxiety at a panic level, and expunged fears secondary to Schizophrenia as evidenced by delusions, inaccurate environmental perception, non-realistic thinking is inappropriate, memory problems/deficiency, and self-centeredness.
Desired Outcomes:
- The patient will express their recognition if delusional beliefs persist.
- The patient will accurately comprehend the environment.
- The patient will demonstrate positive interpersonal relationships.
- The patient’s will demonstrate a reduced anxiety level.
- The patient will not act on his or her deluded thoughts.
- The patient will establish trust in at least one member of the team within one week.
- The patient will maintain attention and concentration to accomplish the activity or activities.
- The patient will report that the “thoughts” are less severe and less frequent with the help of drugs and nursing interventions.
- The patient will talk about concrete events in the environment without mentioning illusions for 5 minutes.
- The patient will demonstrate 2 effective coping methods in order to reduce delusional beliefs.
- The patient will be free of delusions or have the ability to function in the absence of delusional thinking.
| Impaired Memory Nursing Interventions | Rationale |
| At the time of the presentation, try to comprehend the significance of these beliefs to the client. | The client’s seemingly nonsensical dreams can reveal important insights to underlying concerns and issues. |
| Recognize the client’s hallucinations as a reflection of the surroundings. | Understanding the client’s feelings might be as simple as recognizing his or her perception. |
| Explain the procedures and make sure the client understands them before implementing them. | The client is less likely to feel duped by the employees if he or she is fully informed about the procedures. |
| Engage in reality-based activities to divert the client from their fantasies (e.g., card games, simple arts and crafts projects etc.). | The client is free of delusional thinking when his or her thoughts are focused on reality-based tasks. Aids in the externalization of attention. |
| Do not challenge the client’s views or attempt to persuade the client that the delusions are incorrect and unreal at first. | Arguing will just make the customer more defensive, strengthening their false views. The customer will feel even more lonely and misunderstood as a result of this. |
| Demonstrate empathy for the client’s feelings. Provide reassurance by being present and showing acceptance. | The delusion of the customer can be upsetting. Empathy shows that one cares about the client and is interested in them. |
| If a client believes they need to defend themselves from a specific person, use safety measures to safeguard them or others. Precautions must be taken. | During the acute phase, the client’s delusional thinking may lead them to believe that in order to be safe, they must harm others or themselves. It’s possible that external controls are required. |
Nursing Care Plan for Impaired Memory 5
Nursing Diagnosis: Impaired Memory related to chemical alterations in the brain from elevated cortisol secondary to Cushing’s Disease as evidenced by anxiety, depression, insomnia, irritability, and mood changes.
Desired Outcome: The client will demonstrate a normal mental process and improved mentation.
| Impaired Memory Nursing Interventions | Rationale |
| Explain the cause of emotional instability to the client and his or her family. | The body might experience high cortisol levels as anxiety, and insomnia is quite common in clients using steroids and having high cortisol levels. |
| Encourage the individual to talk about their feelings and concerns. | This will help the client express their problems and provide the opportunity to deal with their issues. |
| Provide the customer with a good and caring environment. | Depression may be exacerbated by the dismal effects of a major and incapacitating illness. |
| Use straightforward, plain language and brief words to repeat instructions as needed. | Cushing’s illness can impair a person’s memory and attention. |
| Assist in the psychotherapy of the client. | Cushing’s disease causes melancholy, mood swings, and anxiety, which can be treated with psychotherapy. |
| As directed, provide medications. | These drugs are used to treat elevated cortisol levels caused by tumors, and they may help with some of the psychological problems that come with it. |
Nursing References
Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier. Buy on Amazon
Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon
Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier. Buy on Amazon
Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier. Buy on Amazon
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