An 80-year-old patient becomes apathetic, with decreased alertness and a slowing of speech several days after hip replacement surgery alternating with long periods of lucidity. What is the most likely cause of these symptoms?

Question

Quizplus · Accepted Answer

The patient's symptoms suggest delirium, which is a common complication following surgery in older adults. Delirium is characterized by a fluctuating level of consciousness, changes in attention and cognition, and alterations in perception, activity level, and sleep-wake cycle. It is often caused by a combination of factors, including underlying medical conditions, medications, anesthesia, and surgical stress. The patient's age and hip replacement surgery increase their risk of delirium. Apathy, decreased alertness, and slowing of speech may also be seen in other conditions, including anesthesia effects or stroke, but delirium is the most likely cause in this case based on the timing of symptoms and the patient's history. Pain medications may also contribute to delirium, but would not be the primary cause.

An 80-Year-Old Patient Becomes Apathetic, with Decreased Alertness and a Slowing