A nurse is admitting a client to the hospital unit. Which one of the following elements of the client's history and physical assessment increases the risk for the development of delirium?

A. Elevated erythrocyte sedimentation rate (ESR): Elevated ESR is commonly seen in inflammatory conditions such as pericarditis. ESR measures the rate at which red blood cells settle in a tube of blood over a certain period, and elevated levels indicate inflammation or tissue damage.

B. Increased C-reactive protein (CRP): CRP is an acute-phase reactant produced by the liver in response to inflammation. Elevated CRP levels are indicative of inflammation, making it a useful marker in pericarditis.

C. Elevated thyroid-stimulating hormone (TSH): Elevated TSH levels are not typically associated with pericarditis. TSH is a hormone produced by the pituitary gland that stimulates the thyroid gland to produce thyroid hormones. Elevated TSH levels are seen in conditions such as hypothyroidism.

D. Increased brain natriuretic peptide (BNP): BNP is a hormone produced by the heart in response to increased pressure and volume overload. Pericarditis can lead to increased pressure within the heart, resulting in elevated BNP levels. Therefore, increased BNP levels are anticipated in pericarditis.

E. Increased troponin I: Troponin I is a cardiac biomarker released into the bloodstream when there is damage to cardiac muscle cells. While pericarditis primarily involves inflammation of the pericardium (the sac surrounding the heart), severe cases can lead to myocardial involvement and subsequent release of troponin I. Therefore, increased troponin I levels may be observed in pericarditis, especially if there is myocardial involvement.

A. Muscular aches in the leg: Muscular aches in the leg are not typically indicative of an impending cardiac arrest. While leg pain or cramping can be associated with peripheral vascular disease or venous insufficiency, they are not specific signs of cardiac arrest.

B. Profound fatigue: Profound fatigue can be a warning sign of an impending cardiac arrest. Fatigue or weakness can result from inadequate blood flow to the heart muscle, which may occur prior to a cardiac event. Additionally, systemic effects of cardiovascular compromise can lead to generalized weakness and fatigue.

C. Severe headache: While severe headache can be associated with conditions such as hypertension or intracranial bleeding, it is not a typical manifestation of an impending cardiac arrest. Headaches may occur as a result of stress or anxiety related to the cardiac event, but they are not a direct warning sign of impending cardiac arrest.

D. Ringing in the ears: Ringing in the ears, also known as tinnitus, is not typically associated with an impending cardiac arrest. Tinnitus can result from various factors such as noise exposure, ear infections, or certain medications, but it is not considered a warning sign of impending cardiac arrest.