When an elderly patient is brought into the Emergency Department by family members who reported a fall the nurse became suspicious that the patient had suffered physical abuse. The patient denied that she had been abused. Her denial is most likely based on her.

A. Sweating is a common symptom of opioid withdrawal and is included in the Clinical Opiate Withdrawal Scale (COWS), which is used to assess the severity of withdrawal symptoms.
B. Goosebumps (also called piloerection) are a classic physical sign of opioid withdrawal and are specifically assessed in the COWS scoring system.
C. Palpitations are not typically listed as a core symptom of opioid withdrawal in the COWS assessment. While some individuals may subjectively report feeling anxious or having an increased heart rate, palpitations are not a primary or consistent withdrawal symptom.
D. High blood pressure is a recognized symptom of opioid withdrawal and is measured in the COWS tool as part of autonomic symptoms like increased pulse and blood pressure.

A. Identifying stressors negatively affecting self may be useful in some mental health conditions but is less relevant for delirium caused by fever and dehydration. Delirium is primarily an acute, reversible condition that is related to physiological causes, such as infection or dehydration, rather than emotional or psychological stressors.
B. Demonstrating motor responses to noxious stimuli refers to a neurophysiological response and is not the primary goal in the treatment of delirium. In delirium, the focus is on addressing the underlying cause (e.g., fever, dehydration), managing symptoms, and restoring cognitive function, rather than evaluating motor responses.
C. Returning to premorbid levels of function is the most appropriate and relevant goal for a patient experiencing delirium due to fever and dehydration. Since delirium in this context is often reversible once the underlying causes (such as dehydration and fever) are addressed, the desired outcome is to help the patient recover and return to their previous level of functioning and cognitive baseline. This is the primary goal of treatment for delirium caused by an acute, reversible condition.
D. Exerting control over responses to perceptual distortions could be a helpful goal in managing patients with psychotic or more chronic cognitive conditions, but delirium primarily affects acute cognitive states. While delirium can involve perceptual distortions, the main focus in treating delirium is addressing the underlying causes and promoting recovery to the patient's previous cognitive state.