A client who has sustained severe injuries in a motorcycle accident was diagnosed with intensive care unit (ICU) psychosis. The nurse would be most likely to conclude that the client's status is improving if the client:
1. Increases the number of hours slept at one time and is increasingly alert
2. Appears to be delirious but has stopped trying to pull out the nasogastric tube
3. Tells his wife, "I feel better, but the doctors want to give me a lethal injection."
4. Keeps his eyes fixed on the nurses while they are working in the room but has stable vital signs
1
Rationale: The foreign environment of a hospital's critical care unit, the loss of a normal sleep-wake cycle, effects of injuries, and succumbing to placement of invasive lines, tubes,
and possibly restraints can lead to delirium and feelings of powerlessness. The symptoms of psychosis are more likely to resolve when the client resumes a more normal sleep cycle and is physiologically stable. Improvement from ICU psychosis is evidenced by decreased hallucina-tions, anxiety, and aggressive behavior, along with increased sleep and absence of injuries.
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