hi. i'm a nurse tech at a cardiac hospital. yesterday, a pt, 50 years old, was transferred from icu to our unit post cabg three days ago. the pt is ao x3, but i saw him getting out of bed with his sequential teds on and nasal cannula, trying to walk around, doesn't seem to be aware that he is attached to the equipments. i immediately go in and asked him to have a seat. i told him he needs to use the call bell because he is unsteady and he cried "whah" and didn't say anything else.
later his wife informed me that he had a reaction to the anesthesia from the surgery and ever since he has been acting like a different person and she doesn't even know him anymore. we put the bed alarm on him for safety and later that night he got out of bed, still very confused. i informed the nurse and she didn't do anything about this situation. i went to the charge nurse and she called the pa. when he came, he consoled the wife and told her this is normal.
i would like to learn more about this if anyone has had this experience. i empathize for the wife because it would be puzzling to see my husband act like a completely different person three days post surgery.
i have seen older adults become delusional after taking meds like ambien, morphine but the next day they are back to their old self. how common is this? what can be done to help this patient?
hi. i'm a nurse tech at a cardiac hospital. yesterday, a pt, 50 years old, was transferred from icu to our unit post cabg three days ago. the pt is ao x3, but i saw him getting out of bed with his sequential teds on and nasal cannula, trying to walk around, doesn't seem to be aware that he is attached to the equipments. i immediately go in and asked him to have a seat. i told him he needs to use the call bell because he is unsteady and he cried "whah" and didn't say anything else.
later his wife informed me that he had a reaction to the anesthesia from the surgery and ever since he has been acting like a different person and she doesn't even know him anymore. we put the bed alarm on him for safety and later that night he got out of bed, still very confused. i informed the nurse and she didn't do anything about this situation. i went to the charge nurse and she called the pa. when he came, he consoled the wife and told her this is normal.
i would like to learn more about this if anyone has had this experience. i empathize for the wife because it would be puzzling to see my husband act like a completely different person three days post surgery.
i have seen older adults become delusional after taking meds like ambien, morphine but the next day they are back to their old self. how common is this? what can be done to help this patient?
altered mental status is a cardinal sign that something needs to be investigated ( worked up). best guesses of the cause- is not prudent.
evidenced based care ask that we find out why?. could be infection. could be dvt. could be a need for medication review. could be too soon to discharge.
This is interesting, I had been wondering why it seemed like some of the LVAD pts on our unit seem so disoriented after their LVADS are placed...they can go from being A&O to needing a sitter for quite a while.
2 that jumped out at me were anoxia or ETOH. How about irregular rhythms? I know our docs liberally prescribe metoprolol post-op that even with holding orders sometimes those HRs get a little low.
Usually goes away in a day or two. If not start thinking other things...
2longasn
49 Posts
altered mental status is a cardinal sign that something needs to be investigated ( worked up). best guesses of the cause- is not prudent.
evidenced based care ask that we find out why?. could be infection. could be dvt. could be a need for medication review. could be too soon to discharge.