An 82-Year-Old Man Is Found to Be Agitated and Confused

An 82-year-old man is found to be agitated and confused on day 2 following surgery for a right hip fracture.  The surgery was uncomplicated and was not accompanied by hemodynamic instability.  The patient has a history of mild cognitive impairment and lives at home with his daughter.  He also has hypertension, gout, and benign prostatic hyperplasia.  Temperature is 37.2 C (99 F) , blood pressure is 134/90 mm Hg, and pulse is 100/min.  The patient has 2 peripheral intravenous lines that appear clean.  He does not have a Foley catheter.  Lungs are clear on auscultation.  Heart rhythm is regular with a faint mid-systolic murmur heard over the left sternal border.  The lower abdomen is tender and palpation exacerbates the agitation.  The surgical site appears clean with minimal discharge.  Laboratory results are as follows: Which of the following is the best next step in management of this patient?

A) Abdominal CT scan without contrast
B) Abdominal x-rays
C) Bladder ultrasound
D) Blood cultures followed by intravenous vancomycin
E) Quiet environment and intramuscular haloperidol

Correct Answer:

Verified

Unlock this answer now
Get Access to more Verified Answers free of charge

Access For Free