Chapter 14, Problem 2CAQ

Summary Introduction

To explain:

Mrs. K’s good friend comes to visit her. She is concerned that Mrs. K seems to be confused. She asks if there is anything she could do to help the patient to be less confused. How would you respond to the friend?

Case summary:

Mrs. K is an 81-year-old active and independent retired bookkeeper 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 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.