Causative factors for the development of delirium include which of the following? Select all that apply.

Choice A reason: Applying a clean, dry dressing over the VTE/DVT site is not necessary. VTE/DVT usually involves deep veins where there are no visible wounds requiring dressings. This instruction is irrelevant to the management and discharge instructions for a patient with DVT on anticoagulant therapy.
Choice B reason: Monitoring activated partial thromboplastin time (aPTT) results is relevant for heparin therapy, not for warfarin. Warfarin therapy is monitored using the international normalized ratio (INR). Therefore, this instruction is not appropriate for a patient being discharged on warfarin.
Choice C reason: Administering the warfarin dose at the same time each day is crucial for maintaining consistent blood levels of the medication, ensuring its effectiveness. It helps to maintain steady anticoagulation and reduces the risk of complications associated with fluctuating blood levels of warfarin.
Choice D reason: Instructing the patient to take aspirin or NSAIDs as needed for pain is inappropriate because these medications can increase the risk of bleeding when taken with warfarin. Patients on warfarin should avoid these medications and use alternatives like acetaminophen (Tylenol) for pain relief.
Choice E reason: Advising the patient to use electric razors, not straight razors, when shaving is important to prevent cuts and bleeding. Warfarin increases the risk of bleeding, and using an electric razor minimizes the chance of nicks and cuts that could lead to significant bleeding.
Choice F reason: Monitoring the level of anticoagulation with warfarin using INR results is essential. Regular INR monitoring ensures that the patient maintains a therapeutic level of anticoagulation and helps prevent both clotting and bleeding complications. Adjustments to the warfarin dose are made based on INR results.

Choice A reason:
Receiving a blood transfusion after 1992 does not strongly indicate the need for hepatitis C screening because screening of blood products for hepatitis C became standard practice in the early 1990s. By 2005, the risk of transmission via transfusion had been effectively eliminated. Therefore, while a past transfusion may be part of the patient's health history, it does not necessitate hepatitis C screening in this case.
Choice B reason:
Intravenous drug use, even if it occurred 20 years ago, is a significant risk factor for hepatitis C infection. The virus is commonly transmitted through the sharing of needles or other equipment used to inject drugs. Due to the long latency period of hepatitis C, individuals with a history of IV drug use are at high risk and should be screened regardless of how long ago the exposure occurred. This is the most relevant information in the patient’s history to prompt screening.
Choice C reason:
Frequent dining in fast-food restaurants does not indicate a risk for hepatitis C. Hepatitis C is primarily spread through blood-to-blood contact, not through food or drink. This choice reflects a misunderstanding of the transmission pathways of hepatitis C and is irrelevant to the patient’s screening needs.
Choice D reason:
Traveling to a country with poor sanitation is more associated with the risk of hepatitis A, a virus that is often spread through contaminated water or food. Hepatitis C, however, is not typically transmitted via poor sanitation or contaminated food and water. Screening for hepatitis C would not be warranted based solely on travel history to such countries.