A nurse is collecting data from an admission history for a client who reports being tackled while playing football and is now seeing bright flashes of light and dark floating spots. Which of the following conditions should the nurse expect the client to be experiencing?

A. A client transferred to the medical unit 1 hour ago, after staying 3 days in the ICU for severe blood pressure issues: This client is at the greatest risk for developing delirium due to several factors: recent transfer from the intensive care unit (ICU), history of severe blood pressure issues requiring ICU admission, and the potential for experiencing significant physiological and psychological stressors during the ICU stay. Patients who have been in the ICU are at increased risk for delirium due to factors such as sedative use, mechanical ventilation, and critical illness.

B. A client who has been on the medical unit for a week following a car accident and is waiting for transfer to a rehab facility when a bed becomes available: While this client may have experienced significant trauma from the car accident, they have been stable on the medical unit for a week, which reduces the immediate risk of developing delirium compared to the client recently transferred from the ICU. However, ongoing assessment and monitoring are still necessary.

C. A client who has been NPO for 3 hours, receiving IV fluids, and has not been prescribed any medications: While fasting and receiving IV fluids may contribute to dehydration, which can increase the risk of delirium, this client does not have the same level of acuity or recent history of critical illness as the client transferred from the ICU. Additionally, the absence of prescribed medications reduces the risk of medication-related delirium.

D. A client who is 4 days postoperative following knee surgery and scheduled for discharge home later this morning: This client is in the subacute phase of recovery and is scheduled for discharge home, indicating stability and reduced risk of developing delirium compared to the client recently transferred from the ICU. However, postoperative patients are still at risk for delirium, particularly in the immediate postoperative period, and should be monitored accordingly.

A) "Pentoxifylline can be administered to help the platelets from sticking together and occluding the vessels": Pentoxifylline is a medication used to improve blood flow by decreasing the viscosity of blood. However, it is not typically used to treat mitral valve stenosis. This statement does not accurately reflect treatment options for this condition.

B) "A heparin bolus is administered and followed with a continuous infusion to help keep the blood thinner": Heparin is an anticoagulant used to prevent blood clot formation, but it is not a treatment for mitral valve stenosis itself. While anticoagulants may be used in certain situations with mitral valve stenosis (such as in the setting of atrial fibrillation), they do not directly address the underlying valve narrowing.

C) "A flexible catheter will be inserted into a vessel of the arm, neck, or groin and advanced to the heart to dilate a narrowed or occluded artery": This statement describes a procedure known as percutaneous transluminal mitral valvuloplasty (PTMV), which is a minimally invasive intervention used to treat mitral valve stenosis. During this procedure, a catheter with a deflated balloon on its tip is inserted into a vessel and guided to the heart, where the balloon is inflated to widen the narrowed valve.

D) "A small catheter with a balloon on the end is threaded into a vessel in the groin and advanced to the heart where the balloon will be inflated, and the narrowed valve will be dilated": This statement accurately describes balloon valvuloplasty, which is a common procedure used to treat mitral valve stenosis. By inflating the balloon within the narrowed valve, the procedure aims to widen the valve opening, thus improving blood flow through the heart.