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. "Your heart condition is caused by excessive stretching of the ventricles": Dilated cardiomyopathy (DCM) is characterized by the dilation or enlargement of the heart's chambers, particularly the ventricles. This dilation results in weakened myocardial contraction and impaired systolic function. The primary cause of DCM is often idiopathic (unknown), but it can also be secondary to various factors such as genetics, infections, toxins, or systemic diseases. The statement correctly identifies the pathophysiological basis of DCM as excessive stretching or dilation of the ventricles, leading to impaired cardiac function.

B. "Your heart condition is caused when the ventricular tissue becomes fibrous and fatty": This statement is incorrect. Fibrous and fatty changes in ventricular tissue are characteristic of another type of cardiomyopathy known as hypertrophic cardiomyopathy (HCM), not dilated cardiomyopathy (DCM). In DCM, the primary abnormality is dilation of the heart chambers rather than fibrous and fatty changes in the myocardium.

C. "Your heart condition is caused from stiffening of the walls of the ventricles": This statement describes restrictive cardiomyopathy (RCM), not dilated cardiomyopathy (DCM). In restrictive cardiomyopathy, the ventricular walls become stiff and rigid, impairing diastolic filling and ventricular relaxation. However, in DCM, the primary abnormality is dilation or enlargement of the ventricles rather than stiffening of the ventricular walls.

D. "Your heart condition is caused by thickening of the ventricular walls and septum": This statement describes hypertrophic cardiomyopathy (HCM), not dilated cardiomyopathy (DCM). In HCM, there is abnormal thickening of the ventricular walls and septum, leading to reduced chamber size and impaired diastolic filling. However, in DCM, the primary abnormality is dilation or enlargement of the ventricles rather than thickening of the ventricular walls.

A. Weight loss:

Weight loss can occur in individuals with dementia due to various factors, including decreased appetite, difficulty eating or swallowing, and increased energy expenditure.

Monitoring weight regularly can help detect changes in nutritional status and identify potential health concerns, such as malnutrition or dehydration.

B. Decreased mobility:

Individuals with dementia may experience a decline in mobility and functional abilities as the disease progresses.

Monitoring changes in mobility, such as difficulty walking, transferring, or performing activities of daily living, is important for assessing functional decline and implementing appropriate interventions to maintain mobility and prevent complications such as falls.

C. Increased physical activity:

While dementia can lead to decreased physical activity in some individuals, others may exhibit increased restlessness or wandering behaviors.

Monitoring changes in physical activity levels can help identify agitation, restlessness, or wandering behaviors that may require intervention to ensure the safety and well-being of the individual with dementia.

D. Unkempt appearance:

Individuals with dementia may neglect personal hygiene and grooming tasks, leading to an unkempt appearance.

Monitoring changes in appearance, such as poor personal hygiene, disheveled clothing, or neglect of grooming habits, can indicate difficulties with self-care and may necessitate assistance or supervision to maintain hygiene and appearance.

E. Constipation:

Constipation is a common gastrointestinal symptom in individuals with dementia, often due to factors such as reduced fluid intake, decreased physical activity, and side effects of medications.

Monitoring bowel habits and addressing constipation promptly can help prevent discomfort, complications such as fecal impaction, and maintain overall gastrointestinal health in individuals with dementia.