The nurse working in a long-term care facility completes her ...

[LCritchfi]

The nurse working in a long-term care facility completes her morning assessment on a new postoperative patient and notes a change in cognitive status from the previous day? The nurse recognizes which of the following as a precipitating factor for
 
  delirium? (Select all that apply.) a. Major medical treatment c. Admission to long-term care
  b. Poor sleep habits d. Pharmacological agents

Question 2

A health care provider has ordered alendronate (Fosamax) for an older adult who has been admitted for a hip fracture. Which is the best response from the nurse when educating the patient on the new medication?
 
  a. You will need to have your calcium checked monthly while on this medica-tion.
  b. If you miss a dose, you will need to take the medication as soon as you remember.
  c. Take on an empty stomach.
  d. Do not take with alcohol.

[ryhom]

Answer to Question 1

A, C, D
Major medical treatment, admission to long-term care, and pharmacological agents are all preci-pitating factors for delirium. Changes in surroundings often precipitate delirium. The develop-ment of delirium is a result of complex interactions among multiple causes. Delirium can result from the interaction of predisposing factorsvulnerabilit y on the part of the individual as a re-sult of predisposing conditions, such as cognitive impairment, severe illness, and sensory im-pairment; delirium can also result from precipitating factors and insultsmedications, procedures, restraints, and iatrogenic events. Although a single factor (e.g., infection) can trigger an episode of delirium, several co-existing factors are also likely to be present. A highly vulnerable older individual requires a lesser amount of precipitating factors to develop delirium. Poor sleep habits is not a contributing factor in of itself.

Answer to Question 2

C
Drug-food interactions may either decrease or increase the amount absorbed. For example, when a bisphosphonate such as Fosamax is taken with food of any kind, the absorption is reduced to only a few milligrams; therefore the drug has no effect on the target organthe bones. If a pa-tient misses a dose, then he or she should not take it as soon as remembered; it should be taken at its next scheduled dose. No current recommendations suggest that calcium levels are to be checked monthly.

[LCritchfi]

Excellent

[ryhom]

Thanks for the timely response, appreciate it