A nurse is reinforcing discharge teaching about postpartum activity restrictions to a client who had a cesarean birth 2 days ago. Which of the following statements by the client indicates an understanding of the teaching?

Rationale:

• Past medical history like Parkinson’s disease increases the risk of delirium but is not a direct symptom. It may contribute but does not confirm the presence of delirium alone. Current behavior and cognition changes are more reliable indicators.

• Illusions involve misinterpreting real stimuli, unlike this client’s perception of spiders that aren’t there. Hallucinations are a more accurate description of this experience. Therefore, illusions are less consistent with the actual findings.

• Change in orientation is a hallmark of delirium and is shown by the client’s confusion about the date and location. The sudden onset and fluctuation in awareness suggest an acute cognitive disturbance. This finding supports the development of delirium in the ICU setting.

• Hallucinations, such as seeing spiders that are not present, reflect sensory misperceptions. These are typical in hyperactive delirium and often cause agitation or fear. They indicate an altered mental state requiring urgent assessment.

Rationale:

A. Encourage the client to increase fluid intake: Clients undergoing peritoneal dialysis often have fluid restrictions based on residual renal function and ultrafiltration goals. Increasing fluid intake without specific provider guidance may lead to fluid overload.

B. Obtain the client's weight: Daily weight measurement is essential in peritoneal dialysis to assess fluid removal effectiveness and detect signs of fluid retention or dehydration. Weight changes help guide dialysis fluid volume and concentration adjustments.

C. Palpate the access site for a thrill: A thrill is assessed in clients with an arteriovenous (AV) fistula or graft used for hemodialysis, not peritoneal dialysis. Peritoneal dialysis uses a catheter placed in the abdominal cavity, which does not produce a thrill.

D. Auscultate the access site for a bruit: A bruit is associated with blood flow through an AV fistula or graft used in hemodialysis. In peritoneal dialysis, the access is a soft catheter, and auscultation for a bruit is not applicable or expected.