The nurse is caring for a client in the medical-surgical unit who has delirium according to the Confusion Assessment Method assessment tool. Which of the following assessment findings are likely contributing to the client's delirium? Select all that apply.
A) Multiple doses of IV hydromorphone administered in the past 12 hours
B) Serum sodium of 123 mEq/L (123 mmol/L)
C) SpO2of 82% on room air
D) Temperature of 103.1 F (39.5 C)
E) Urine culture positive for gram-positive cocci in chains
Correct Answer:
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