A nurse is caring for a group of clients with dementia. The nurse recognizes which of the following factors as reasons for the growing numbers of clients diagnosed with dementia in the United States?
(Select All that Apply.)

A. Female sex: While gender can influence the risk of certain health conditions, such as cardiovascular diseases, there isn't a direct correlation between being female and an increased risk of delirium. Both males and females can develop delirium under certain circumstances.

B. History of drug and alcohol use: A history of drug and alcohol use increases the risk for the development of delirium. Substance abuse, including alcohol, illicit drugs, and certain prescription medications, can disrupt neurotransmitter function and lead to alterations in mental status, including delirium. Additionally, withdrawal from alcohol or drugs can precipitate delirium in susceptible individuals.

C. Lack of medical insurance: While access to healthcare and socioeconomic factors can impact overall health outcomes, there isn't a direct association between lack of medical insurance and an increased risk of delirium. Delirium is more closely linked to medical conditions, substance use, and other physiological factors.

D. History of lymphoma: While certain medical conditions, such as infections, metabolic disturbances, and neurological disorders, can increase the risk of delirium, there isn't a direct correlation between a history of lymphoma and the development of delirium. Delirium is more commonly associated with acute illness, surgery, or medication use.

A) Computed tomography (CT) scan: A CT scan may provide detailed images of the heart and surrounding structures, but it is not typically the initial diagnostic test used to assess for cardiac tamponade. CT scans are often used in conjunction with other diagnostic tests but are not the first-line investigation for suspected tamponade.

B) Chest x-ray: While a chest x-ray may show signs of cardiac tamponade, such as an enlarged cardiac silhouette or evidence of fluid accumulation around the heart, it is not as sensitive or specific as other diagnostic tests, particularly in the acute setting. Chest x-rays may be obtained as part of the diagnostic workup, but they are not the first-line test for suspected tamponade.

C) Echocardiogram: An echocardiogram is the most appropriate initial diagnostic test for suspected cardiac tamponade. It provides real-time imaging of the heart and can detect pericardial effusion, collapse of the right atrium and ventricle during diastole (diastolic collapse), and signs of hemodynamic compromise. Echocardiography allows for rapid assessment at the bedside and can guide immediate management decisions.

D) Electrocardiogram (ECG): While an electrocardiogram may show nonspecific changes in cardiac tamponade, such as low-voltage QRS complexes or electrical alternans, it is not as sensitive or specific as an echocardiogram for diagnosing tamponade. ECG findings may support the diagnosis but are not typically the first-line test for suspected tamponade.