The nurse is caring for a patient whose recent health history includes an altered level of consciousness. What should be the nurse’s initial action when assessing this patient?

Choice A rationale
While participation in multiple-step activities can provide mental stimulation, it may be challenging for a patient with Alzheimer’s disease. These activities often require a level of cognitive functioning that may be impaired in Alzheimer’s patients. As a result, these activities could lead to frustration and agitation rather than fostering socialization.
Choice B rationale
Hobbies involving fine motor skills can be beneficial for maintaining dexterity and coordination. However, as Alzheimer’s disease progresses, these skills often decline. Therefore, while these hobbies may be enjoyable, they may not necessarily foster socialization.
Choice C rationale
Limiting visitors to one or two at a time can help to prevent overstimulation, which can be distressing for a person with Alzheimer’s disease. Smaller, more intimate gatherings can also foster more meaningful social interactions. Therefore, this approach can be beneficial for promoting socialization.
Choice D rationale
While social interaction is important for people with Alzheimer’s disease, frequent lengthy visits from friends may be overwhelming and lead to fatigue. It’s important to balance socialization with rest and relaxation. Therefore, promoting frequent lengthy visits may not be the best approach to foster socialization.

Choice A rationale
Postoperative delirium is a common condition that can occur in older patients after surgery, especially major procedures like hip arthroplasty. It is characterized by a sudden onset of confusion and altered consciousness. This type of delirium is indeed treatable and most patients’ cognition will return to its previous levels. The treatment often involves addressing the underlying causes, such as pain, medication effects, or metabolic imbalances, and providing supportive care. It’s important for the family to understand that this is a temporary condition and does not indicate a permanent change in their loved one’s mental status.
Choice B rationale
While anesthetics can contribute to postoperative delirium, the condition is usually multifactorial and not solely due to the anesthetic used in surgery. Therefore, administering antidotes to the anesthetic is not typically how postoperative delirium is managed. Instead, the focus is on treating the underlying causes and providing supportive care.
Choice C rationale

Delirium does involve a disturbance in cognition, including memory impairment, but it does not involve a progressive decline in memory loss and overall cognitive function. That description is more characteristic of dementia, a different condition. Delirium is typically a temporary condition that improves once the underlying cause is addressed.
Choice D rationale
While postoperative delirium is often self-limiting, meaning it resolves on its own over time, it is not accurate to say there is nothing to worry about. Postoperative delirium can be distressing for the patient and their family, and in some cases, it can be associated with longer hospital stays and increased morbidity. Therefore, it is a condition that should be taken seriously and managed appropriately.