A patient with chronic obstructive pulmonary disease is hospitalized for respiratory distress and has improved. She becomes very anxious when experiencing shortness of breath
One evening she is found to be restless and disorganized in her behavior and conversation. Which of the following should be considered first in determining the possible causes of these changes? a. She is becoming more anxious as her respiratory status worsens.
b. The multiple neurocognitive changes may be due to hypoxia.
c. Her anxiety is increasing due to fears of decreasing independence.
d. She is exhibiting early signs of dementia due to chronic hypoxia.
B
Hypoxia can mimic anxiety by causing restlessness, purposeless or repetitive activity, disorganization, and confusion. Persons with chronic obstructive pulmonary disease are often anxious about shortness of breath and the impact of their illness on their future health and independence, but because hypoxia presents a risk to the patient's health and safety, this potential cause of the patient's presentation should be considered first. Dementia develops slowly, unlike the acute mental status changes seen here.
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