Delirium (10 Questions)

1. Mme Tremblay, 82 years old, is currently hospitalized on Day 3 post-op for a hip fracture repair. The nursing assistant reports that Mme Tremblay has been very "easy" to care for today because she has been sleeping almost the entire shift, has barely touched her lunch tray, and stares blankly at the wall when awake. She answers questions with one-word mumbles and seems unable to focus on the conversation.
Vital Signs: BP 110/70, HR 88, SpO2 95%.

Question:
Based on these clinical manifestations, what do you suspect is happening to the patient? *
2. M. Gagnon, 79 years old, is brought to the ER by his daughter. She states, "My father has mild memory issues usually, but this morning he didn't know who I was, he was talking about the year 1960, and he couldn't pay attention to anything I said. It happened so fast!"

Question:
Which specific feature mentioned by the daughter confirms the likelihood of delirium rather than a progression of dementia? *
3. Mme Roy, 88 years old, is a resident in a long-term care facility. She suddenly becomes agitated, paces the hallway, and accuses the staff of stealing her purse. This is a new behavior for her.

Medical History: Diabetes, Hypertension.

Question:
What is the priority nursing assessment to determine the cause of this behavior? *
4. M. Boucher, 74 years old, is in the ICU with "Hyperactive Delirium." He is trying to pull out his IV line and his Foley catheter. He is shouting at the ceiling.

Medical Order: Restraints PRN.

Question:
According to nursing standards and ethical guidelines, what intervention must be attempted before applying wrist restraints? *
5. Mme Lefebvre, admitted for pneumonia, points to the corner of the room and screams, "There is a man with a knife standing there! Help me!" She is visibly terrified and trembling.

Question:
What is the most appropriate response? *
6. M. Poirier, 85 years old, was admitted yesterday for a fractured ankle. He was alert on admission. Tonight, he is confused and picking at the air. You review his new medication orders.

Question:
Which medication administered this evening is the most likely trigger for his delirium? *
7. You are the primary nurse for Mme Cloutier. You suspect she is suffering from delirium. You need to perform a standardized assessment to confirm your suspicion before notifying the physician.

Question:
Which assessment tool is the "Gold Standard" for detecting delirium? *
8. M. Lambert, 91 years old, is being admitted to your unit. He has severe cataracts and hearing loss. He appears anxious and is asking, "Where am I?" repeatedly.

Question:
What is the most effective nursing intervention to prevent the onset of delirium in this patient? *
9. Mme Dubois has been experiencing delirium for 2 days. She is awake all night yelling and sleeps deeply during the day.

Question:
What intervention should be included in the care plan to restore her circadian rhythm? *
10. The son of M. Fortin, a patient with acute delirium due to a severe urinary tract infection (UTI), is crying. He asks, "My father has lost his mind completely. Is he going to be crazy like this forever? Do I need to find a nursing home?"

Question:
What is the accurate information to provide to the son? *