The older male adult was oriented and responded correctly in the hospital, but he is dis-oriented and confused in his home after discharge

Question

Which is the first issue the home nurse should examine to determine if an environmental issue is contributing to the patient's condition at home? a. Complaints of shivering
b. Temperature of household
c. Types of food preparation
d. Patient indicators of injury

Answer 1

B

Feedback
A Incorrect. Asking about shivering can be ineffective with an older adult who is confused and disoriented because the response can be incorrect. However, to display respect, the nurse should ask the question.
B Correct. Older adults are at higher risk of hypothermia in the community because hypothermia is difficult to detect and because, as hypothermia sets in, the older adult can respond to a lower temperature. This man has clinical indicators of hypothermia, so the home care nurse assesses the ambient temperature first for a baseline determination because the household temperature should have the most profound impact on his body temperature.
C Incorrect. The type of food preparation can offer additional clues about the older adult's hypothermia and mental status because, if he is eating cold foods like sandwiches and yogurt, he can be contributing to the problem unwittingly.
D Incorrect. The nurse assesses the older adult who is disoriented and confused for injury as a likely cause of a change in mental status. However, because the older adult was not confused and was oriented in the hospital, the nurse looks for clinical indicators for environmental factors.