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15 Cards in this Set
- Front
- Back
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NOC for delirious pt is pt will return to ? level of functioning, pt will remain ? and ? from injury while in the hospital, pt will be oriented to ?,?, and ?
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premorbid,
safe, free, person, place, time |
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We should perform a comprehensive nursing ? to aid in identifying the cause of the delirium.
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assessment
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NIC for delirium include assess VS and ? status on an ongoing basis.
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neurological
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What is the first thing that needs to be done in order to help clear up the delirium?
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Identify the etiology of the delirium
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If the pt is restless we need to assess if the pt is any ?, or may need to be repositioned in ?, are they lacking ? Intervention in one of these areas may ? the behavior and need for ? use and restraint.
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pain,
bed, sleep, decrease, medication |
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Th level of consciousness in delirium is ? The level of consciousness in dementia is ? and the level of consciousness in depression is ?
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altered,
not altered, not altered |
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Acitivity level with delirium can be ? or ? and sleep wake cycle may be ? Activity level with dementia is not ? but behaviors may worsen in the ? Activity levels for depression are usually ? with lack of motivation, lethargy, may sleep ? and awaken early.
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increased or decreased,
reversed, altered, evening, decreased, poorly |
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Emotional state for delirium can consist of ? swings, they can be fearful and ? With dementia pts usually have a ? affect and can be ? With depression we can see extreme ?, apathy, ?, anxiety, and ? ideation.
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rapid,
aggresive, flat, delusional, sadness, irritability, paranoid |
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With speech and language delirium pts may have rapid, ?, ?, rambling. Dementia pts may have slow ? speech due to trying to find a word. Depressed pts will have a slow, ?, low speech pattern.
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inappropriate,
incoherent, incoherent, flat |
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The prognosis for delirium is that it can be ?, for dementia it is ?, and for depression it is ?
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reversible,
non-reversible, reversible |
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The pt is fearfull and has psychomotor agitation. She realizes that her thoughts are all jumbled signaling a cognitive problem. What is this pts problem?
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delirium
pg 374 |
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The nurse should ? with the patient whenever the pt is awake b/c short periods of social interaction help reduce ? and ?
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interact,
anxiety, misperceptions |
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? should always be suspected as a potential cause of delirium, so all medications both ? and ? should be assessed.
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medications,
prescibed, over the counter |
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Medical management of delirium involves treating the underlying ? causes. If the underlying cause of delirium is not treated, permanent ? damage may occur.
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organic,
brain |
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Judicious use of ? or ? meds may also be useful in controlling behavior symptoms.
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antipsychotic,
antianxiety |
