A nurse is caring for a client with delirium who is experiencing illusions. What environmental conditions should the nurse arrange for this client?
Have the client sit by the nurse's desk while awake in a room with the television on
Provide a well-lit room without glare or shadows and limit noise
Keep the room shadowy with soft lighting around the clock, and keep a radio on continuously
Light the room brightly around the clock and awaken hourly to check mental status
The Correct Answer is B
B. This option promotes a calming and supportive environment that minimizes sensory stimuli and helps maintain orientation, reducing the risk of exacerbating symptoms of delirium and illusions.
A. Having the client sit by the nurse's desk may provide some supervision and reassurance, but keeping the television on can contribute to sensory overload and increase confusion, especially if the client is experiencing illusions.
C. Keeping the room shadowy with soft lighting and continuously playing a radio may create an environment that is disorienting and confusing for the client with delirium.
D. Maintaining bright lighting around the clock may disrupt the client's sleep-wake cycle and exacerbate symptoms of delirium. Interrupting the client's sleep by awakening hourly for mental status checks can also contribute to sleep deprivation and increase agitation and confusion
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Related Questions
Correct Answer is B
Explanation
B. This option promotes a calming and supportive environment that minimizes sensory stimuli and helps maintain orientation, reducing the risk of exacerbating symptoms of delirium and illusions.
A. Having the client sit by the nurse's desk may provide some supervision and reassurance, but keeping the television on can contribute to sensory overload and increase confusion, especially if the client is experiencing illusions.
C. Keeping the room shadowy with soft lighting and continuously playing a radio may create an environment that is disorienting and confusing for the client with delirium.
D. Maintaining bright lighting around the clock may disrupt the client's sleep-wake cycle and exacerbate symptoms of delirium. Interrupting the client's sleep by awakening hourly for mental status checks can also contribute to sleep deprivation and increase agitation and confusion
Correct Answer is A
Explanation
A. Walking with the client at a gradually slower pace can provide support and reassurance while helping to regulate the client's activity level. This approach acknowledges the client's distress and offers physical companionship during a challenging time.
B. Instructing the client to sit down and stop pacing may be perceived as confrontational or dismissive of the client's distress. For individuals with generalized anxiety disorder, pacing often serves as a coping mechanism to manage feelings of agitation or restlessness.
C. While ensuring the client's safety is important, forcibly removing them from the corridor may exacerbate feelings of distress or agitation. It is essential to respect the client's autonomy and use interventions that promote de-escalation and emotional support.
D. While allowing the client to pace alone may initially seem like a non-intrusive approach, it may not address the client's underlying emotional distress or provide therapeutic support.
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