Nursing Management of a Patient with Delirium in the Intensive Care Unit: A Case Report

Abstract

Delirium is an acute disturbance in attention, awareness, and cognition that frequently occurs among critically ill patients. Early identification and appropriate nursing management are essential because delirium may increase the risk of complications and prolong hospitalization. This case report describes the nursing management of a 68-year-old male who developed delirium during intensive care unit admission for severe community-acquired pneumonia and acute hypoxemic respiratory failure. On the 3rd day of hospitalization, the patient developed acute changes in mental status, fluctuating attention, disorientation, agitation, disturbed sleep, and visual hallucinations. Assessment using the Confusion Assessment Method for the Intensive Care Unit supported the presence of delirium. Comprehensive nursing interventions were implemented, including regular neurological and delirium assessment, maintenance of oxygenation, reorientation, therapeutic communication, environmental modification, sleep promotion, sensory support, pain assessment, hydration and nutritional support, early mobilization, prevention of injury, and family involvement. Potentially reversible contributing factors were identified and communicated to the multidisciplinary team. Following implementation of the nursing care plan and treatment of the underlying medical condition, the patient’s cognitive status progressively improved. The case highlights the important role of medical-surgical and critical care nurses in early recognition, prevention of complications, and comprehensive management of delirium in critically ill patients.