Delirium nursing

Barbiturates have litde or no analgesic action, so the nurse does not give these drug if die patient has pain and cannot sleep. Barbiturates, when given in the presence of pain, may cause restiessness, excitement, and delirium. 

Impairment of memory, delirium and immobility are some of the adverse dmg reactions from benzodiazepines. Elderly patients in nursing homes often receive benzodiazepines inappropriately (Oborne et al. 2003). The frailest elderly, who are most susceptible to ADR from benzodiazepines, use these drugs and often for long term. In a Japanese study it was shown that benzodiazepines were prescribed for longer terms as patient age increased (Nomura et al. 2007). Sometimes elderly patients in nursing homes are treated with benzodiazepines without actually talking to their nurse or physician (Holmquist et al. 2005). This makes it hard evaluate the treatment. 

Behavior Checklist We chose about 30 items that seemed to characterize the changes seen in delirium from words and phrases we found among entries made by physicians and nurses in earlier charts. At scheduled intervals, nurses translated their clinical observations into values of 0, 1 or 2 on each item and subsequently added them up to obtain a composite numerical score. 

The client who is a chronic alcoholic is admitted to the medical unit for pneumonia. Which medication would the nurse expect the health-care provider to prescribe to prevent delirium tremens ... 

The management of delirium, once recognized, essentially consists of good nursing care and commonsense management. As we will see so often in this book, there is a massive gap between what everyone knows should be done and what actually happens to the patient. 

The nurse may observe central nervous system (CNS) symptoms, including altered mental status with paresthesias, delirium, convulsions, seizures, and coma, as well as muscle cramping, tetany, and hyperexcitability (Chvostek and Trousseau signs). In addition, hypotension and heart failure, as well as a pronlonged QT interval, may be noted. Long-term hyperphosphatemia can result in vascular wall calcification and arteriosclerosis with increased blood pressure and ventricular hypertrophy. 

A patient is admitted in delirium tremens. History shows an intake of a quart of alcohol each day. The patient is 30 pounds under weight. The nurse would anticipate which of the following treatments to address the magnesium imbalance the patient is at highest risk for ... 

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