A nurse is visiting an 84-year-old woman living at home and recovering from hip surgery
The woman seems confused and has poor skin turgor, and she states that "she stops drinking water early in the day because it is too difficult to get up during the night to go to the bathroom." The nurse explains to the woman that:
A) She will need to have her medications adjusted and be readmitted to the hospital for a complete workup.
B) Limiting fluids can create imbalances in the body that can result in confusion; maybe we need to adjust the timing of your fluids.
C) It is normal to be a little confused following surgery and it safe not to urinate at night.
D) Confusion following surgery is common in the elderly due to loss of sleep.
Ans: B
Feedback: In elderly patients, the clinical manifestations of fluid and electrolyte disturbances may be subtle or atypical. For example, fluid deficit may cause confusion or cognitive impairment in the elderly person. Option A is incorrect; there is no mention of medications in the stem of the question or any specific evidence given for the need for readmission to the hospital. Options C and D are incorrect; confusion is never normal, common, or expected in the elderly.
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