A nurse is caring for a client in the intensive care unit. Which of the following laboratory values could contribute to an episode of delirium?

White blood cell level of 5,900 mm3

Potassium level of 4.1 mEq/L

Hemoglobin level of 14.2 g/dL

Blood glucose level of 254 mg/dL

Answer and Explanation

The Correct Answer is D

A. White blood cell level of 5,900 mm3: While abnormal white blood cell levels can indicate infection or inflammation, they are not typically associated with directly contributing to an episode of delirium. However, underlying conditions that cause abnormal white blood cell levels, such as infection or inflammation, may contribute to delirium.

B. Potassium level of 4.1 mEq/L: Potassium imbalances can lead to various neurological symptoms, including weakness, paralysis, and cardiac arrhythmias. However, a potassium level of 4.1 mEq/L is within the normal range and is unlikely to directly contribute to an episode of delirium.

C. Hemoglobin level of 14.2 g/dL: Hemoglobin levels reflect the oxygen-carrying capacity of the blood and are not directly associated with delirium. While severe anemia or hypoxia can cause neurological symptoms, a hemoglobin level of 14.2 g/dL is within the normal range and is unlikely to directly contribute to delirium.

D. Blood glucose level of 254 mg/dL: Elevated blood glucose levels, as indicated by a blood glucose level of 254 mg/dL, can contribute to an episode of delirium. Hyperglycemia can lead to alterations in cerebral metabolism, neuronal dysfunction, and impaired cognitive function, predisposing individuals to delirium. Additionally, hyperglycemia can exacerbate preexisting neurological conditions and increase the risk of developing delirium in critically ill patients. Therefore, monitoring and managing blood glucose levels are essential in preventing and managing delirium in hospitalized patients.

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Correct Answer is A

Explanation

A. Rheumatoid arthritis: Rheumatoid arthritis is an autoimmune condition characterized by chronic inflammation of the joints. Some research suggests a possible link between autoimmune disorders such as rheumatoid arthritis and Meniere's disease. Autoimmune conditions can affect the inner ear, leading to vestibular dysfunction and contributing to the development of Meniere's disease.

B. Bacterial pneumonia: Bacterial pneumonia is a respiratory infection caused by bacterial pathogens. There is no direct association between bacterial pneumonia and an increased risk of developing Meniere's disease. Meniere's disease primarily affects the inner ear and is not related to respiratory infections.

C. Macular degeneration: Macular degeneration is a degenerative eye disease that affects the central portion of the retina. There is no known association between macular degeneration and an increased risk of developing Meniere's disease. These conditions affect different parts of the body and are not related in terms of etiology or risk factors.

D. Osteoporosis: Osteoporosis is a condition characterized by loss of bone density, leading to an increased risk of fractures. There is no direct association between osteoporosis and an increased risk of developing Meniere's disease. These conditions affect different systems in the body and are not known to be related.

A. Assess palmar reflex. B. Assess for cough reflex. C. Assess the ability to follow simple commands. D. Assess for Cushing's Triad. E. Assess for abnormal posturing.

Correct Answer is ["A","B","C","D","E"]

Explanation

A. Assess palmar reflex. Assessing the palmar reflex helps evaluate the integrity of the nervous system, particularly in response to tactile stimuli. In clients with severe TBI, abnormal reflexes may indicate neurological impairment and guide further assessment and intervention.

B. Assess for cough reflex. Assessing the cough reflex is important for evaluating airway protection and the risk of aspiration, especially in clients with reduced consciousness level due to TBI.

C. Assess the ability to follow simple commands. Assessing the client's ability to follow simple commands provides valuable information about their level of consciousness and cognitive function. It helps determine the extent of neurological impairment and guides the plan of care, including interventions for communication and cognitive deficits.

D. Assess for Cushing's Triad. Cushing's Triad, characterized by hypertension, bradycardia, and irregular respirations, may occur as a late sign of increased intracranial pressure (ICP) in clients with severe TBI. Monitoring for Cushing's Triad is crucial for early recognition of elevated ICP and prompt intervention to prevent further neurological damage.

E. Assess for abnormal posturing. Assessing for abnormal posturing, such as decerebrate or decorticate posturing, helps evaluate neurological function and localize brain injury in clients with TBI. Abnormal posturing indicates severe brain damage and may guide decisions regarding treatment and prognostication.

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A nurse is caring for a client in the intensive care unit. Which of the following laboratory values could contribute to an episode of delirium?

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