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He complains of pain in his left hip and says he doesn’t think he has had any pain medication today.

However, you know he received morphine 4 hours ago. In a scenario like this, the nurse should ask herself if delirium could be causing the patient’s signs and symptoms.

Using a standardized assessment tool, evaluate the patient for delirium signs and symptoms during each shift or when you note cognitive changes.

Several valid and reliable standardized tools exist for delirium screening.

Monitor vital signs to help identify complications, such as infection and dehydration.Lawrence Jeffries, age 78, is admitted to the hospital for an arthroplasty of the left hip.A retired roofer, he lives with his wife and son in a two-story home.For example, low blood pressure may suggest dehydration, irregular breathing may indicate hypoxia, and an elevated temperature might reflect dehydration or infection.Review prescribed medications, as some drugs may cause adverse effects that increase delirium risk.Patients with a positive screen require further evaluation by a physician or an advanced practice nurse to identify the cause and initiate appropriate interventions. Jeffries for delirium, based on her observation of excessive drowsiness, his wife’s report of him picking at his bedding, and his complaint of pain despite his medication. These results indicate a positive screen for delirium, so she immediately contacts the physician to ensure a more thorough evaluation.