An elderly male develops bradycardia and has a pacemaker surgically implanted.Although he was lucid preoperatively and has no history of dementia,at 10:00 PM on the night of his surgery,he becomes disoriented to place and time and insists on going home.When placed in soft restraints,he becomes hostile and is later caught trying to burn his way out of the restraints with a cigarette lighter.Which of the following charted observations would best indicate that a priority outcome has been achieved?

Question

Quizplus · Accepted Answer

The patient is likely experiencing a postoperative delirium and is fearful because he is unable to recognize his surroundings and understand his situation.His efforts to leave and go to a familiar environment (home),when coupled with impaired judgment,place the patient at risk of harm to self and others.Thus "No further elopement attempts" indicates that interventions to calm and orient the patient have been successful and that a key source of risk (fear and its resulting elopement efforts)has been reduced.The restraints are an intervention,not an outcome,and might have been counterproductive in calming the patient.The pulse would be expected to be regular and within a safe range,given that he is being paced."Conversing quietly" suggests that the patient has calmed but does not provide any information about possible continued disorientation,fearfulness,impaired judgment,or intent to elope.

An Elderly Male Develops Bradycardia and Has a Pacemaker Surgically