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Altered mental status nursing diagnosis6/14/2023 ![]() Overnight, she had urinary incontinence, which prompted placement of a catheter and initiation of tolterodine (Detrol) for bladder spasm. In the intensive care unit, oral food and fluids were withheld initially and the patient was given levofloxacin (Levaquin), methylprednisolone, nebulizer treatments, and ranitidine (Zantac). The patient's daughter reported that her mother did not comply with her chronic obstructive pulmonary disease inhaler regimen because of drowsiness brought on by the codeine. Five days earlier, she had visited the emergency department for shoulder pain and was given acetaminophen with codeine. ![]() In older persons, delirium increases the risk of functional decline, institutionalization, and death.Ī 91-year-old woman with minimal English proficiency was admitted to the intensive care unit for an exacerbation of chronic obstructive pulmonary disease. Pharmacologic interventions should be reserved for patients who are a threat to their own safety or the safety of others and those patients nearing death. Treatment of delirium should focus on identifying and managing the causative medical conditions, providing supportive care, preventing complications, and reinforcing preventive interventions. Preventive interventions such as frequent reorientation, early and recurrent mobilization, pain management, adequate nutrition and hydration, reducing sensory impairments, and ensuring proper sleep patterns have all been shown to reduce the incidence of delirium, regardless of the care environment. Certain medications, sensory impairments, cognitive impairment, and various medical conditions are a few of the risk factors associated with delirium. Caregivers should be educated on preventive measures, as well as signs and symptoms of delirium and conditions that would indicate the need for immediate evaluation. Assessment for and prevention of delirium should occur at admission and continue throughout a hospital stay. It is common in older persons in the hospital and long-term care facilities and may indicate a life-threatening condition. Delirium is defined as an acute, fluctuating syndrome of altered attention, awareness, and cognition.
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