A nurse in a long-term care facility is caring for a client.
The nurse should identify that which of the following conditions places the client at an increased risk for developing delirium?

Choice A rationale:

Use projection during group therapy. Projection involves attributing one's own thoughts, feelings, or characteristics to another person. It is not an appropriate goal for a client with antisocial personality disorder in a therapeutic setting. Instead, the focus should be on helping the client take responsibility for their actions and develop pro-social behaviors.

Choice B rationale:

Decrease the number of verbal outbursts. This is a suitable goal for a client with antisocial personality disorder. Clients with this disorder may exhibit impulsive and aggressive behaviors, including verbal outbursts. Decreasing such outbursts is a positive therapeutic goal that can contribute to improved interpersonal relationships and overall functioning.

Choice C rationale:

Increase self-esteem. While improving self-esteem is important in many therapeutic settings, it may not be the primary goal for a client with antisocial personality disorder. The primary focus is often on addressing antisocial behaviors, impulsivity, and aggression, as these are the hallmark traits of this disorder.

Choice D rationale:

Use bargaining skills for behavioral consequences. Using bargaining skills may not be the most appropriate goal for a client with antisocial personality disorder. This disorder is characterized by a persistent pattern of violating the rights of others and a disregard for social norms. Instead of bargaining, the emphasis should be on developing empathy, impulse control, and more pro-social ways of interacting with others. .

Choice A rationale:

Hypertension, while a medical condition, is not a direct risk factor for delirium. Delirium is typically associated with factors such as infection, medication side effects, metabolic imbalances, or acute changes in medical conditions, rather than chronic conditions like hypertension.

Choice B rationale:

Neuropathy is also not a direct risk factor for delirium. Delirium is more commonly associated with acute changes in neurological status or conditions that affect brain function.

Choice C rationale:

A white blood cell (WBC) count of 13,000/mm³ is an elevated count and may indicate an underlying infection or inflammation. Infection and inflammation are common causes of delirium, making an elevated WBC count a potential risk factor for developing delirium.

Choice D rationale:

A blood urea nitrogen (BUN) level of 16 mg/dL is slightly elevated but is not a direct risk factor for delirium. Delirium is more often associated with metabolic imbalances, electrolyte abnormalities, or acute changes in kidney function. A BUN level of 16 mg/dL alone is not a major contributor to delirium. .