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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.
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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.
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Chapter 14 Solutions
Fundamentals of Nursing, 9e
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