Reference no: EM133618122

Problem

Mental Health & Wellness in Later life

Case Study: Delirium

68-year-old Mr. Antonov (he/him) is admitted to a medical/surgical nursing floor following an open cholecystectomy. He has a history of peripheral vascular disease, peptic ulcer disease, and hypertension. He works full-time as an accountant. His wife remains at the bedside, working on crossword puzzles. She has her husband's reading glasses in her purse. Mr. Antonov uses the call light asking for children to be removed from the room, as he cannot sleep with their noise. Upon arriving at the bedside, the nurse asks him to repeat his request. His eyes remain closed. The nurse gently asks again and palpates his shoulder; Mr. Antonov looks at the nurse, saying, "Huh? What?" before closing his eyes again. His blood pressure is 110/72 mm Hg, pulse is 68 beats per minute, respirations 14 breaths per minute and temperature 100°F (36.9°C). The abdominal dressing is intact with a dime sized area of serosanguinous drainage. Bowel sounds are hypoactive. Laboratory values include lipase of 100 IU/L, amylase of 130 IU/L, and urine positive for leukocyte esterase and nitrites. White blood cell count is 17.5 × 109/L and neutrophils are 85%. Medications include cefazolin 500 mg IV every 8 hours and morphine 2.5 mg IV every 2 hours as needed for severe pain; hydrocodone/acetaminophen 5 mg/325 mg every 4 hours as needed for moderate pain and acetaminophen 650 mg every 4 hours as needed for mild pain.

Task

What signs/symptoms is Mr. Antonov displaying that would lead you to consider delirium? What could be potential causes of his delirium? Which 5 interventions will the nurse contribute to the plan of care for this client?