Delirium: an under-recognized problem.
Ms. G, a 78-year-old woman with a history of heart failure and a left ventricular ejection fraction of 45%, had an exploratory laparotomy with colon resection and colostomy two days ago for an obstructive stage IIIB adenocarcinoma of the colon. She is a patient on a general surgical unit. Upon assessment at 7 am, Ms. G was easily aroused and oriented. She has a patient-controlled analgesia (PCA) pump for postoperative pain control with 1 mg of morphine available every 30 minutes; she used a total of 4 mg of morphine via IV since midnight. Ms. G requires belladonna and opium suppositories about every eight hours to treat bladder spasms associated with her urinary catheter.
Bethesda North Hospital, TriHealth Inc., Cincinnati, OH, USA. debra_heidrich@trihealth.com
Debra E
DE
Heidrich
D000230:Adenocarcinoma / Q000601:surgery; D000368:Aged; D016058:Analgesia, Patient-Controlled / Q000009:adverse effects*; D000701:Analgesics, Opioid / Q000009:adverse effects*; D001533:Belladonna Alkaloids / Q000009:adverse effects; D015984:Causality; D003110:Colonic Neoplasms / Q000601:surgery; D003125:Colostomy / Q000009:adverse effects; D003693:Delirium / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D009020:Morphine / Q000009:adverse effects; D009730:Nursing Assessment; D009892:Opium / Q000009:adverse effects; D010149:Postoperative Pain / Q000188:drug therapy / Q000209:etiology; D011182:Postoperative Care / Q000379:methods / Q000451:nursing; D014546:Urinary Catheterization / Q000009:adverse effects
D000701:Analgesics, Opioid; D001533:Belladonna Alkaloids; D009020:Morphine; D009892:Opium