(^470) Medical-Surgical Nursing Demystified
PROGNOSIS
Delirium is often due to an underlying infection, ischemic change, or metabolic
disturbance. Rapid identification and intervention for the underlying cause is essen-
tial for the patient. Without proper treatment the cause may prove to be fatal.
HALLMARK SIGNS AND SYMPTOMS
- Confusion
- Disorientation
- Behavioral changes
- Inappropriate words or dress
- Agitation
INTERPRETING TEST RESULTS
- EEG shows generalized slowing.
- WBC elevated in bacterial infection.
- Glucose abnormalities in hyper- or hypoglycemia.
- EKG abnormalities in myocardial ischemia or infarction.
- CT scan of brain shows ischemic changes.
- Electrolyte abnormalities if causative.
TREATMENT
- Monitor vital signs.
- Monitor neurologic status, orientation, level of consciousness, eye opening,
and pupil response. - Treatment of underlying cause.
- Supplemental oxygen delivery if hypoxic.
NURSING DIAGNOSIS
- Risk for falls