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

Answer and Explanation

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.

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Correct Answer is D

Explanation

Choice A reason: Idiopathic pulmonary fibrosis is a chronic, progressive lung disease characterized by scarring of the lung tissue. Tissue plasminogen activators (tPAs) are not used for this condition, as they are primarily designed to dissolve blood clots, not to address fibrotic changes in the lungs.

Choice B reason: Sarcoidosis is an inflammatory disease that affects multiple organs, particularly the lungs and lymph glands. It involves the growth of tiny collections of inflammatory cells called granulomas. Tissue plasminogen activators are not used in the treatment of sarcoidosis since the condition is not related to blood clots but rather to immune system dysregulation.

Choice C reason: Atelectasis is the complete or partial collapse of a lung or lobe of a lung due to alveoli deflation. The treatment typically focuses on re-expanding the lung tissue through techniques such as deep breathing exercises, bronchoscopy, or mechanical ventilation. Tissue plasminogen activators are not relevant for this condition, as they are used to dissolve blood clots, not to treat lung collapse.

Choice D reason: Pulmonary embolus (PE) is a blockage in one of the pulmonary arteries in the lungs, usually caused by blood clots that travel to the lungs from the legs or other parts of the body (deep vein thrombosis). Tissue plasminogen activators are used to treat PE because they can effectively dissolve the blood clots obstructing the pulmonary arteries, thereby restoring normal blood flow and preventing further complications.

A. Synthroid B. PTU (Propylthiouracil) C. Tapazole D. Propranolol

Correct Answer is A

Explanation

Choice A reason: Synthroid (levothyroxine) is the most commonly prescribed medication for hypothyroidism. It is a synthetic form of thyroxine (T4), which replaces the deficient hormone in patients with hypothyroidism and helps normalize their thyroid function.

Choice B reason: PTU (Propylthiouracil) is typically used for the treatment of hyperthyroidism, not hypothyroidism. It works by inhibiting the synthesis of thyroid hormones.

Choice C reason: Tapazole (methimazole) is also used for the treatment of hyperthyroidism, similar to PTU. It is not used to treat hypothyroidism.

Choice D reason: Propranolol is a beta-blocker that is used to manage symptoms of hyperthyroidism, such as tremors and palpitations. It does not treat hypothyroidism.

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Which patient problem is a significant risk factor for the development of delirium in the intensive care unit (ICU)?

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Explanation

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Correct Answer is A

Explanation

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