Table 3 perioperative nursing implications: preventing and treating delirium in elderly patients
Preoperative care
-Establish a therapeutic relationship with the patient and family members.
-Provide a safe and calm environment , recognizing the cognitive , psychosocial , and behavioral needs of elderly patients to include
-orienting and reorienting the patient as needed and
-limiting r=environmental disruption.
-obtain a relevant history , to include
-performing cognitive screening using the Geriatric Depression Scale or Mini-Cog Test;
-performing delirium screening using the confusion Assessment Method (CAM);
-identifying risk factors that may increase the patient’s possibility of experiencing delirium;
-documenting a thorough medication history and performing a medication reconciliation; and
-reviewing all laboratory values and diagnostic screening( eg , complete blood count,metabolic panel, blood glucose levels, urinalysis and culture, chast x-ray).
-Monitor and regulate fluid volume.
-Encourage family members to participate in the patient’s care.
- Encourage the patient’s to communicate with staff members’
-Provide comforting measures during invasive procedures.
-Incorporate the patient’s routine in the plan of care.