![Fundamentals of Nursing, 9e](https://www.bartleby.com/isbn_cover_images/9780323327404/9780323327404_largeCoverImage.gif)
Concept explainers
To identify:
The conditions prompt during the assessment to suspect that the patient has delirium.
Case summary:
Mrs. K is an 81-year-old woman admitted to the hospital for an emergency hip pinning surgery for her hip fracture followed by a fall at her home. She also had other medical problems such as hypothyroidism, hypertension, and anxiety disorders for which she is also taking medications. In the past, she had bilateral knee replacements. She is active and independent living, retired bookkeeper. She drives, plays cards with her friends and also participates in the church activities. She wears glasses and uses a cane.
Mrs. K’s postoperative medical report showed that she is been receiving opioids for pain and has intravenous fluids for hydration. She has an indwelling urinary catheter. The nurse reported that Mrs. K was restless and slept only a little all night. Her pain medications did not help her to sleep. The nurse while entering Mrs. K’s room found that she is picking at the air as she was trying to eat the breakfast and she is founded to be self-orienting. During the shift assessment, the nurse recognizes the signs of delirium in Mrs. K.
![Check Mark](/static/check-mark.png)
Explanation of Solution
The orientation status and the condition of the distraction of not being able to eat prompted to the suspicion of delirium in Mrs. K.
Delirium is a state of mind that is characterized by incoherence, fever, restlessness, agitations, hallucinations, task distractions, and illusions. Mrs. K was found to be restless and was unable to sleep in the night after the surgery. The status of her orientation has also changed after the surgery. She is found to be not in a control and her distraction during eating is the typical assessment of delirium. The occurrence of urinary tract infections due to the indwelling catheter might also cause delirium.
The conditions that prompt to suspect that Mrs. K has delirium are her disorientation status and distracted behavior while having food.
Want to see more full solutions like this?
Chapter 14 Solutions
Fundamentals of Nursing, 9e
- DaVita Dietitian Reference Manual Module 7- Adequacy of Hemodialysis CASE STUDIES Case 1 David was diagnosed with chronic kidney disease a year ago, and now needs hemodialysis. At his first treatment, the nurse hooks up the bloodlines to an access in David's chest. He tells her that he had surgery on his arm three months ago so it can be used for dialysis eventually. 1. What type of access does David have for the initial treatment? 2. Is David's arm access most likely a graft or fistula? 3. What possible reasons prevent use of a fistula or graft for the first dialysis treatment? Case 2 Ramon, a hemodialysis patient for six years, has lost 1.5 kg over the past six weeks. He denies nausea or vomiting, but does admit to eating less at meals and skipping dinner some days. Current dialysis prescription is: 3 1/2 hours (210 minutes), 3 times a week, ASAHI 1050S, APS dialyzer, dialysis flow rate 800 ml/min, blood flow rate 400 ml/min. Monthly bloodwork is as follows: Date K PO4 Pre-BUN…arrow_forwardDaVita Dietitian Reference Manual Module 7 - Adequacy of Hemodialysis REVIEW QUESTIONS True False 1. 27 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. Urea Reduction Ratio is a more accurate measurement of dialysis adequacy than Urea Kinetic Modeling. A fistula is the preferred type of vascular access. In the formula Kt/V, the V represents volume of total body water in which urea is distributed. In the formula Kt/V, time is measured in 15-minute increments, so 220 minutes would be rounded off to the nearest quarter hour. The DaVita minimum goal for adequacy is a spKt/V≥ 1.0. A measured height and accurate dry weight are required to obtain an accurate Kt/V result. A very low post BUN result usually means the patient is not eating enough protein. KRU is a measure of residual urea clearance by the patient's kidney, requiring a 24-hour urine collection. The Kt/V Delivered (single pool) is the value used for determining adequacy and comparing outcomes in DaVita facilities. Catheters are…arrow_forwardDaVita Dietitian Reference Manual Module 7 - Adequacy of Hemodialysis Case 3 Beverly's monthly adequacy of dialysis results came back lower than usual. Her Kt/V is 1.13. Flow sheet data reveals the following: Prescribed BFR 400, patient ran BFR 325 during treatment Blood pressure dropped to 72/58 during treatment, so UFR was turned off. Dry weight 65 kg, pre dialysis weight 69 kg, post dialysis weight 66.5 kg 1. What are DaVita's goals for Kt/V? 2. What is your impression of why the Kt/V is low? 3. What additional information would help in determining why Beverly's adequacy results were below goal?arrow_forward
- DaVita Dietitian Reference Manual Module 7-Adequacy of Hemodialysis DISCUSSION QUESTIONS Define the following abbreviations: • UKM • URR . . • Kt/V What are the minimum DaVita outcome goals for Kt/V and URR? How is the DaVita Quality Index calculated for Kt/V? Discuss effect of adequacy on: ⚫ Phosphorus . ⚫ Potassium • Hemoglobin • Appetite, intake and weight ⚫ Albumin . How is residual renal function measured? What term is used for residual clearance of urea? What are advantages and disadvantages of each dialysis access? Which dialyzes the least efficiently and why?arrow_forwardNutrition monitoring and evaluating ptarrow_forwardIs a blood pressure of 117/71 considered normal in an 11 month old male?arrow_forward
- Question #1: Have there been any hospital mergers in Kern County,CA? If so, describe the hospital merger (describe only one merger-there are several). Here are some hints for your research: Tehachapi hospital AND Adventist Health; Memorial Hospital AND CHW/Dignity Health; Dignity Health AND Catholic Health Initiatives. Describe only one merger-there are several to choose from. Question #2: What happened to Westside District Hospital in Taft, CA? PLS PROVIDE REFERENCE TO BACK YOUR ANSWERS TO EACH.arrow_forwardNutrition Intervention Nutrition Monitoring & Evaluation Needed: Protein sources Amount to eat daily Protein and other foods high in phosphorus (I.e. cheese, legumes) Cooking method of protein sources Urine produced daily Dividing fluids throughout the day Types of fluid Acceptable fluids (Le. ginger ale) Fluids to avoid (I.e. dark colas) Food considered fluid (I.e. jello) Tips to reduce thirst How would you educate the pt?arrow_forwardWhy does a dietitian manager need to know about the importance of herbs in their scope of practice and how it can impact their work performance.arrow_forward
- As a nursing student with a tgrow and smart goal of being able to identify key sources of fear and anxiety in school age patients related to hospitalization. Meaningfully reflects on TGROWs and S.M.A.R.T. goals,offering specific examples of their use in conflict, growth, or discomfort.arrow_forward5:48 PM • REC 440 ASSIGNMENT What are the diagnostic modalities used by the pathologist? Describe the course of disease. What are the purposes of tissue fixation What is pathogenesis? III = AU O narrow_forwardAs a nursing student with a smart goal of being able to identify common sources of fear and anxiety in school age patients, describe how this influence future growth in reflective practice with detailed and/or relevant insights.arrow_forward
- Phlebotomy EssentialsNursingISBN:9781451194524Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)Publisher:JONES+BARTLETT PUBLISHERS, INC.Gould's Pathophysiology for the Health Profession...NursingISBN:9780323414425Author:Robert J Hubert BSPublisher:SaundersFundamentals Of NursingNursingISBN:9781496362179Author:Taylor, Carol (carol R.), LYNN, Pamela (pamela Barbara), Bartlett, Jennifer L.Publisher:Wolters Kluwer,
- Fundamentals of Nursing, 9eNursingISBN:9780323327404Author:Patricia A. Potter RN MSN PhD FAAN, Anne Griffin Perry RN EdD FAAN, Patricia Stockert RN BSN MS PhD, Amy Hall RN BSN MS PhD CNEPublisher:Elsevier ScienceStudy Guide for Gould's Pathophysiology for the H...NursingISBN:9780323414142Author:Hubert BS, Robert J; VanMeter PhD, Karin C.Publisher:SaundersIssues and Ethics in the Helping Professions (Min...NursingISBN:9781337406291Author:Gerald Corey, Marianne Schneider Corey, Cindy CoreyPublisher:Cengage Learning
![Text book image](https://www.bartleby.com/isbn_cover_images/9781451194524/9781451194524_smallCoverImage.gif)
![Text book image](https://www.bartleby.com/isbn_cover_images/9780323414425/9780323414425_smallCoverImage.gif)
![Text book image](https://www.bartleby.com/isbn_cover_images/9781496362179/9781496362179_smallCoverImage.jpg)
![Text book image](https://www.bartleby.com/isbn_cover_images/9780323327404/9780323327404_smallCoverImage.gif)
![Text book image](https://www.bartleby.com/isbn_cover_images/9780323414142/9780323414142_smallCoverImage.gif)
![Text book image](https://www.bartleby.com/isbn_cover_images/9781337406291/9781337406291_smallCoverImage.gif)