Brief Patient History Mr. A is an 87-year-old man. He has a history of aortic stenosis; however, he has been relatively healthy until recent episodes of syncope. Mr. A lives in an assisted living facility because of forgetfulness but was independent in activities of daily living before this hospitalization.Clinical Assessment Mr. A was admitted to the critical care unit yesterday, after undergoing aortic valvuloplasty. Mr. A has not received any opioids or benzodiazepines since yesterday’s interventional procedure. The night nurse reported that Mr. A was confused to place when awakened during the night but commented that this is normal for an 87-year-old. This morning, Mr. A was oriented to person, time, place, and situation. He is easily aroused but dozes off and on when unstimulated. Although Mr. A is able to follow simple commands, he requires repeated instructions. The nurse failed to document or report the patient’s mental status change or the abnormal serum electrolyte findings to the physician.Diagnostic Procedures Mr. A’s baseline vital signs are blood pressure, 110/62 mm Hg; heart rate, 82 beats/min (sinus rhythm); respiratory rate, 18 breaths/min; and temperature, 98.4°F. The chest radiograph is normal; O2 saturation (pulse oximetry) is 96% on room air. Results from serum electrolyte analysis include the following: sodium, 120 mmol/L; potassium, 4.1 mmol/L; chloride, 95 mmol/L; CO2, 25 mEq/L; blood urea nitrogen, 60 mg/dL; and creatinine, 2 mg/dL.Medical Diagnosis Mr. A is diagnosed with delirium secondary to hyponatremia.Questions1. What major outcomes do you expect to achieve for this patient?2. What problems or risks must be managed to achieve these outcomes?3. What interventions could be initiated to monitor, prevent, manage, or eliminate the problems and risks identified?4. What interventions could be initiated to promote optimal functioning, safety, and well-being of the patient?5. What technology can be used to monitor this patient and prevent complications?6. What other interprofessional team members are needed to assist with the management of this patient?7. What possible learning needs would you anticipate for this patient?8. What cultural and age-related factors might have a bearing on the patient’s plan ofHealth ScienceScienceNursing NUR 103

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