Risk for delirium?

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We were talking in class the other day about "risk for delirium" and our teacher said it would make a great diagnosis. I happen to have a patient that fits the bill we discussed in class, but in both my diagnosis books, I can't find a risk for delirium dx...So what do I do if I can't find a resource?

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Specializes in Hospitalist Medicine.

Well, think about it. What's another word or phrase for delirium? That'll give you the answer you're looking for. Keep looking in your NANDA or nursing diagnosis book and you'll find it :D

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

The is not risk for "delirium" diagnosis. A person who had delirium is not oriented to place and time so that makes them _____.

Find that diagnosis.

ON a side note..you instructor should have suggested that to you at the time of the discussion.

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Risk for acute confusion?

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Ok, I'm going with that. =] I'm still working on my 3 dx, but I'd like to post them later to get opinions. This is my last chance to save myself for the semester!

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Risk for acute confusion?
Yup! is this the patient was talked about the other day?
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Hmm, I don't think it was. I don't remember posting about her yet... But, here are some reasons I felt I was pointed to delirium - she is 68, she had previously been admitted with septicemia and was admitted again last Friday with septicemia again. She has short gut syndrome. Her BUN/creatinine is very high. She has hx of chronic kidney disease. Her albumin is low. Her h&h is low. Let's see...low sodium, high potassium. She even sounded confused when I spoke with her. There is no hx of confusion in her h&p. A fellow student had her weeks ago and she didn't remember her being confused. She is also on fentanyl and morphine. Also vancomycin. Would these factors go well with risk for confusion?

Our teacher was telling us no patient should get to delirium, it can be seen as a "failure to rescue" so if a patient has the recipe for delirium, they need to be closely watched and risk for delirium, or better said confusion would make a great dx.

Also, thinking of electrolyte imbalance as another dx...?

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Specializes in Hospitalist Medicine.

OK, you found the word I was hinting at. Now, what do you think your patient is "telling" you? Acute? Chronic? What do you think would be most appropriate according to what S&SX she's got and what you saw when you did your assessment? You're pointed in the right direction.

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Well, since she has no history of confusion, and from talking to a fellow student who had her before and didn't notice any confusion, I'd say risk for acute confusion.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Hmm, I don't think it was. I don't remember posting about her yet... But, here are some reasons I felt I was pointed to delirium - she is 68, she had previously been admitted with septicemia and was admitted again last Friday with septicemia again. She has short gut syndrome. Her BUN/creatinine is very high. She has hx of chronic kidney disease. Her albumin is low. Her h&h is low. Let's see...low sodium, high potassium. She even sounded confused when I spoke with her. There is no hx of confusion in her h&p. A fellow student had her weeks ago and she didn't remember her being confused. She is also on fentanyl and morphine. Also vancomycin. Would these factors go well with risk for confusion?

Our teacher was telling us no patient should get to delirium, it can be seen as a "failure to rescue" so if a patient has the recipe for delirium, they need to be closely watched and risk for delirium, or better said confusion would make a great dx.

Also, thinking of electrolyte imbalance as another dx...?

You still are looking at medical information and not your patient assessment. It is entirely possible that she wasn't confused a few weeks ago and now is confused due to polypharmacy and just illness/hospital admission alone. That would make this acute confusion and not a risk of because she is actually confused.

You are missing the point altogether. You have it set in your head what YOU want and not what the PATIENT actually NEEDS.

What did she actually say that makes you think she was confused?

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This is what she said that made me think she was confused:

Appeared confused aeb stated, “My friend is 5 years younger than me. She is 57 and I’m 68 so, let’s see, she is 11 years older than I am.” Also repeatedly asked who the night nurse that took care of her last time she was at Kindred and was confusing names.

I performed a head to toe with the teacher in the room and she agreed the patient seemed confused.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

right. so..... if she IS PRESENTLY confused it is no longer a risk is it?

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