All of the following are symptoms of hyperactive delirium except

A. Providing a safe, non-intimidating, and supportive environment is the most crucial intervention. It allows the patient to feel comfortable and safe enough to disclose sensitive information, like domestic violence. Creating an environment where the patient feels supported and free from judgment is key to encouraging disclosure.
B. Speaking with the patient in the absence of her husband is important, but it is not enough by itself. While the husband may be the abuser, the emotional and physical safety provided by the healthcare team in a supportive environment is essential for disclosure.
C. Interviewing her in the presence of another healthcare professional may be helpful in some situations but can be intimidating if not done carefully. The primary concern is ensuring that the patient feels comfortable and safe to speak freely.
D. Allowing the patient to initiate the topic of violence may not always work, especially if the patient feels threatened, afraid, or emotionally overwhelmed. While it's important to respect the patient's autonomy, being proactive in providing a safe space can encourage her to disclose abuse more readily.

A. Patient will remain safe in the environment is the priority outcome in both delirium and dementia scenarios. In both conditions, the patient is at an increased risk of harm due to confusion, misinterpretation of reality, and impaired judgment. Ensuring the patient's safety is the first and foremost concern. This could involve managing the patient's environment, preventing falls, using safety measures like bed alarms, and ensuring that wandering is minimized.
B. Patient will acknowledge reality is a desirable goal but not the immediate priority in these cases. In delirium, the patient's altered reality is typically reversible once the underlying cause is addressed. In dementia, reality orientation may be difficult or impossible to fully achieve, so safety is more important.
C. Patient will communicate verbally is important, but in these cases, the patient's safety is more critical. Communication abilities may vary depending on the severity of the delirium or dementia, and focusing on verbal communication may not address the more immediate need for safety.
D. Patient will participate actively in self-care is an important goal for promoting independence, but in the case of delirium and dementia, ensuring the patient's safety must be prioritized first, as these conditions may impair the patient's ability to perform self-care activities safely.