The family of a client in the ICU expresses their concern because their family member is confused and disoriented. The best explanation by the nurse is:
1. "This is expected in older clients with dementia."
2. "You can help us reverse this problem."
3. "You are visiting too much and disrupting care."
4. "The client might not recover from the confusion."
Answer: 2
1. Older clients with dementia are not the only clients who experience ICU psychosis. All clients in that environment are at risk without intervention by the nurse and family.
2. The nurse should explain the problem to the family and then teach the family strategies that they can use to help the client reduce and reverse confusion.
3. It is not possible for families to visit too much. They are critical to the well-being of the client.
4. Confusion in the ICU client is reversible with caring interventions by nurses and family.
You might also like to view...
A patient receiving an epidural analgesic complains of a headache. Which of the following should the nurse suspect?
a. Catheter migration b. Local anesthesia toxicity c. Common side effect of the analgesic d. Dural puncture
An obstetric nurse is caring for a patient in preterm labor. The nurse implements an order for IV magnesium sulfate. Which clinical manifestations would indicate that the patient has received too much of the medication?
a. Temperature of 104.4° F b. Paralytic ileus c. Hypertension d. Confusion
Appropriate nursing interventions for a client with cachexia would include which of the following?
a. assisting in self-care activities to improve outward appearance b. encouraging the client to eat any foods that are appealing c. scheduling regular exercise time d. providing a bland diet high in vitamins A and D
Which of the following complications would the nurse expect to observe in the client with progressive dysphagia and a history of achalasia?
A. Aneurysm B. Weight loss C. Pneumothorax D. Esophageal varices