A 75-Year-Old Woman Is Evaluated for Agitation and Confusion While

question 168

Multiple Choice

A 75-year-old woman is evaluated for agitation and confusion while hospitalized.  She was admitted 4 days ago due to fever, productive cough, and shortness of breath.  The patient was diagnosed with community-acquired pneumonia and her condition has improved with antibiotics.  However, for the past 2 days, she has had episodes of confusion and agitation, especially during the evening and night.  The patient's medical history includes hypertension, osteoarthritis, and mild dementia.  She lives with her husband at a senior living facility and is able to perform her daily activities with minimal assistance.  Her temperature is 37.0 C (98.6 F) , blood pressure is 130/80 mm Hg, and pulse is 84/min.  Pulse oximetry is 98% on room air.  The patient recognizes her husband at the bedside but is not oriented to time or location.  During the examination, she repeatedly tries to climb out of bed but calms when reoriented.  The patient follows simple instructions and has no focal weakness or sensory loss.  She has moist mucous membranes and crackles in the right upper lung.  Laboratory testing shows an improving leukocytosis and normal electrolytes.  Which of the following would be most helpful in managing this patient's current condition?

• A)Encourage bed rest to minimize falls
• B)Initiate low-dose benzodiazepine therapy
• C)Limit the patient's interactions with family members
• D)Provide sensory overstimulation to keep the patient attentive
• E)Reduce nighttime noise and disturbances
• F)Use soft bilateral physical restraints

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Definitions:

Treatment for Adolescents with Depression Study (TADS)

A landmark research project evaluating the effectiveness of different treatments for adolescents suffering from depression.

Antidepressant Medication

Antidepressant medication is used to treat major depressive disorder and other conditions by balancing chemicals in the brain to improve mood and emotions.

Cognitive-behavioral Therapy

Psychotherapy centered on boosting well-being and tackling challenges by adjusting negative emotions, actions, and thoughts.

Placebo Treatment

A treatment or procedure that is given to a control group during research studies which has no therapeutic effect but is identical in appearance to the actual treatment being tested.