An older man was oriented and responded appropriately in the hospital, but he is now disoriented and confused in his home after discharge
Which of the following issues is the first that the home nurse should examine to determine whether 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. Presence of radon
B
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; therefore the home care nurse first assesses the ambient temperature for a baseline determination because the household temperature should have the most profound impact on his body temperature. Asking about shivering can be ineffective with an older adult who is confused and disoriented; the response can be incorrect. However, to display respect, the nurse should ask the question. The type of food preparation can offer addi-tional clues about the older adult's hypothermia and mental status; if he is eating cold foods such as sandwiches and yogurt, then he can be unwittingly contributing to the problem. Presence of radon in the home may lead to lung cancer, not confusion.
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