Nursing Case Study: Delirium, Pain Management and Strength-Based Approach

Running head: NURSING CASE STUDY
NURSING CASE STUDY
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NURSING CASE STUDY
Introduction
The incidence of delirium is significantly higher in the older adults characterized with
impaired cognitive abilities and lack of awareness about the environment (Lawlor & Bush,
2014). The condition is diagnosed by a cognitive assessment to monitor and evaluate the
cognitive capacity of the affected individual that directs the treatment process and helps to
develop intervention strategies for the patient by accessing the physical and mental needs of the
patient (Lawlor & Bush, 2014). Health care professions especially the nurses working in such
settings are responsible for conducting necessary assessments required to access and understand
the patient’s condition more comprehensively and accurately that would help to plan and
implement the intervention strategies appropriate for the patient. The paper focuses on an
incident experienced by the protagonist of the video, Max, who is a delirium patient and
discusses on the nursing interventions by aligning with the Nursing and Midwifery Board of
Australia standards for managing the patients of delirium like Max.
Question 1:
Delirium is a serious and acute neuropsychiatric disorder characterized with cognitive
dysfunction and the etiology of the condition implicates the pathophysiological significances of
acute medical illnesses and complications or drug intoxication. The condition is diagnosed by a
cognitive assessment to monitor and evaluate the cognitive capacity of the affected individual
that directs the treatment process and helps to develop intervention strategies for the patient by
accessing both the physical and mental needs of the patient.

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NURSING CASE STUDY
Depending on the etiology and clinical severity, delirium can be of three types that
includes hyperactive, hypoactive and a mixed level of activity. It is evident from the studies that
hypoactive delirium is associated with severe complications and have resulted into a higher rate
of mortality among the individuals because of the difficulty in its diagnosis. Patients with
hyperactive delirium are disorientated, agitated and delusional and experience hallucinations.
Hypoactive delirium patients are subdued, disoriented and confused. However, the study by
Evensen et al., 2019, suggests that older people with delirium demonstrates a reduced activity
and there are no significant differences found between the three types of delirium, probably due
to poor gait function (Evensen et al., 2019).
According to the Diagnostic criteria of delirium IV, delirium is diagnosed by monitoring the
following criteria:
 Disturbances in consciousness, awareness and attention.
 Impaired cognition
 Inability to understand and interpret information stated by others.
 Collecting and accessing the patient’s history and through physical assessments that helps
to find the gather subjective and objective data of the patients and help to plan or develop
the intervention and treatment strategies.
 Other associated psychological issues identified in this area sleep disturbances, delusions,
inappropriate behaviour, emotional liability and perceptual disruptions. Delirium patients
are likely to suffer from a combinations of the above conditions needs serious treatment
and assistance both medical and psychological.