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An 82-Year-Old Man Is Found to Be Agitated and Confused

question 17

Multiple Choice

An 82-year-old man is found to be agitated and confused on day 2 following surgery for a right hip fracture. The surgery was uncomplicated and was not accompanied by hemodynamic instability. The patient has a history of mild cognitive impairment and lives at home with his daughter. He also has hypertension, gout, and benign prostatic hyperplasia. Temperature is 37.2 C (99 F) , blood pressure is 134/90 mm Hg, and pulse is 100/min. The patient has 2 peripheral intravenous lines that appear clean. He does not have a Foley catheter. Lungs are clear on auscultation. Heart rhythm is regular with a faint mid-systolic murmur heard over the left sternal border. The lower abdomen is tender and palpation exacerbates the agitation. The surgical site appears clean with minimal discharge. Laboratory results are as follows: $An 82-year-old man is found to be agitated and confused on day 2 following surgery for a right hip fracture. The surgery was uncomplicated and was not accompanied by hemodynamic instability. The patient has a history of mild cognitive impairment and lives at home with his daughter. He also has hypertension, gout, and benign prostatic hyperplasia. Temperature is 37.2 C (99 F) , blood pressure is 134/90 mm Hg, and pulse is 100/min. The patient has 2 peripheral intravenous lines that appear clean. He does not have a Foley catheter. Lungs are clear on auscultation. Heart rhythm is regular with a faint mid-systolic murmur heard over the left sternal border. The lower abdomen is tender and palpation exacerbates the agitation. The surgical site appears clean with minimal discharge. Laboratory results are as follows: Which of the following is the best next step in management of this patient? A) Abdominal CT scan without contrast B) Abdominal x-rays C) Bladder ultrasound D) Blood cultures followed by intravenous vancomycin E) Quiet environment and intramuscular haloperidol$ Which of the following is the best next step in management of this patient?

Definitions:

Classical Conditioning

A learning process through which associations are made between a natural stimulus and a neutral stimulus to elicit a behavior.

Observation

The action or process of closely monitoring or watching something or someone carefully in order to gain information.

Operant Behavior

Operant behavior involves actions that are controlled by their consequences, a concept fundamental to operant conditioning theories in psychology.

Environmental Conditions

The physical and biological factors along with their chemical interactions that affect an organism or a group of organisms.