Case Study Postoperative Delirium Patient Profile M.C.

Question

Case Study Postoperative Delirium Patient Profile M.C. is a 74 Case Study Postoperative Delirium Patient Profile: M.C. is a 74-year-old male who has been in the intensive care unit (ICU) for 3 days after unexpected major abdominal surgery. He is becoming increasingly confused and agitated. Before surgery, he was alert and oriented. Subjective data indicates he states he needs to “get out of here,” showing anger at family members for not “taking me home,” while family members are very upset about M.C.’s confusion. Objective data includes blood pressure at 110/70, pulse at 98, respirations at 20, and temperature at 97.3°F. His oxygen saturation is 97% on nasal cannula oxygen at 2L. His abdominal incision is healing with no redness or drainage. He has difficulty speaking, decreased short-term memory and recall, is trying to climb out of bed, is oriented to person only, has difficulty focusing attention, and exhibits disorganized thinking. Answer the following questions thoroughly and cite resources appropriately in APA format: What type of cognitive impairment does M.C. likely have? How can this diagnosis be confirmed? Are there any other issues that you need to consider as possible causes for his mental state? What is the nurse’s priority regarding M.C.’s mental status? What is the next priority for the nurse caring for M.C.? What diagnostic tests may be ordered and what would each contribute? How will you support M.C.’s family at this time? Complete the attached CAM worksheet for this patient and discuss the results here.

Dr. Jack HW Helper · Accepted Answer

Postoperative delirium is a common complication in elderly patients following major surgeries. In M.C.'s case, the likely cognitive impairment he is facing is delirium, characterized by acute confusion and fluctuating levels of consciousness. Delirium can occur due to various factors such as metabolic imbalances, medications, infections, or the surgical procedure itself (Inouye, 2006). The diagnosis of delirium can be confirmed by using assessment tools such as the Confusion Assessment Method (CAM), which consists of key features such as acute onset, inattention, disorganized thinking, and altered level of consciousness (Inouye et al., 1990). In M.C.'s case, his disorientation, difficulty focusing, and agitation suggest a significant risk of delirium. Furthermore, diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders (5th ed.), indicate that these symptoms must not be attributable to a pre-existing neurocognitive disorder (American Psychiatric Association, 2013). Other potential issues that may contribute to M.C.'s mental state include postoperative pain, medications such as sedatives or analgesics, and potential complications like hypoxia or metabolic dysregulation (Kapoor et al., 2020). These factors must be considered as they may further exacerbate his confusion and agitation. The nurse’s priority regarding M.C.'s mental status is to ensure his safety. Given that he is trying to climb out of bed, which poses a fall risk, implementing safety measures such as bed alarms, assisting with mobility, and providing adequate supervision is essential (Kearney et al., 2019). Additionally, the nurse should closely monitor M.C.'s vital signs and mental status to assess for any changes that may require intervention. The next priority for the nurse caring for M.C. would be to determine the underlying cause of his delirium. This could involve reviewing his medication regimen for sedatives or other agents that could impair cognition, assessing laborat

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Case Study Postoperative Delirium Patient Profile M.C. is a 74

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