Which patient problem is a significant risk factor for the development of delirium in the intensive care unit (ICU)?
Type 2 diabetes mellitus
Alcohol abuse
Anxiety
Impaired communication
The Correct Answer is B
Choice A reason: Type 2 diabetes mellitus, while a serious chronic condition, does not directly predispose patients to delirium. Diabetes primarily impacts the body's ability to regulate blood glucose levels, leading to complications such as cardiovascular disease, neuropathy, and nephropathy. However, it is not directly linked to the acute cognitive disturbances seen in delirium unless it leads to severe metabolic derangements, which is less common.
Choice B reason: Alcohol abuse is a significant risk factor for the development of delirium, especially in ICU patients. Chronic alcohol use can lead to a condition known as delirium tremens (DTs) during withdrawal, characterized by severe agitation, confusion, hallucinations, and autonomic hyperactivity. Patients with a history of alcohol abuse may have altered brain chemistry and neurotransmitter imbalances that predispose them to delirium when stressed by illness or surgery. Moreover, alcohol abuse can lead to liver dysfunction, nutritional deficiencies (particularly thiamine), and other systemic issues that further exacerbate the risk.
Choice C reason: Anxiety can exacerbate stress and discomfort in a patient but is not a primary causative factor for delirium. Anxiety may contribute to an increased sense of fear or confusion, especially in an ICU setting. However, it does not cause the profound disruption in cognitive function, attention, and awareness that characterizes delirium.
Choice D reason: Impaired communication might be a consequence or symptom seen in patients with delirium, but it is not a root cause. Patients with pre-existing communication difficulties might struggle more to express symptoms or needs, which could complicate care, but it does not inherently lead to the onset of delirium. Effective communication strategies and aids can help manage these challenges but do not address the underlying neurological changes seen in delirium.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: While elevated bilirubin levels can indicate liver dysfunction and lead to jaundice, they are not the primary cause of hepatic coma. Bilirubin is a byproduct of red blood cell breakdown and its accumulation can cause yellowing of the skin and eyes.
Choice B reason: Calcium levels, whether high or low, can affect neuromuscular function and cardiac health, but they are not directly associated with causing hepatic coma. Hypercalcemia or hypocalcemia can present with various symptoms, but not typically with hepatic coma.
Choice C reason: Elevated ammonia levels are directly associated with hepatic coma. In patients with severe liver dysfunction, the liver cannot efficiently convert ammonia (a byproduct of protein metabolism) into urea for excretion. The accumulation of ammonia in the blood can cross the blood-brain barrier and lead to encephalopathy, resulting in confusion, altered mental status, and potentially hepatic coma.
Choice D reason: Sodium levels can affect neurological function, particularly with conditions like hypernatremia or hyponatremia. However, these imbalances are not the primary cause of hepatic coma. The direct link to hepatic coma is through elevated ammonia levels.
Correct Answer is D
Explanation
Choice A reason: Cantaloupe and cottage cheese are not particularly high in iron. While cantaloupe provides vitamin C, which can enhance iron absorption, the overall iron content of this meal is low, making it less effective for treating iron-deficiency anemia.
Choice B reason: Cornmeal muffin and orange juice offer some nutrients, including vitamin C from orange juice, which helps with iron absorption. However, cornmeal muffins do not provide significant iron content, making this choice suboptimal for iron-deficiency anemia.
Choice C reason: Strawberry and banana fruit plate provides vitamins and minerals, including vitamin C from strawberries, but it lacks substantial iron content. This choice is not adequate for addressing iron-deficiency anemia.
Choice D reason: Omelet and whole wheat toast are excellent choices for increasing dietary iron intake. Eggs in the omelet provide heme iron, which is easily absorbed by the body, and whole wheat toast contains non-heme iron. Combined, they offer a balanced and effective meal for managing iron-deficiency anemia.
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