Question

A patient who has been unable to sleep for several nights has experienced a change in mental status. He does not know what day it is, or where he is. His speech and movements are slowed, and he seems dazed and stupefied. He cannot follow simple directions such as, "Hold out your hand." Which nursing diagnosis is most appropriate for this patient?

1) Insomnia
2) Dementia
3) Depression
4) Delirium

Answer 1

The most accurate diagnosis for the patient described, who has acute cognitive changes after several nights without sleep, is delirium, which manifests with confusion, disorientation and difficulty with attention and memory.

Step-by-step explanation:

The most appropriate nursing diagnosis for a patient experiencing a change in mental status characterized by disorientation, slowed speech and movements, a dazed state, and an inability to follow simple directions after several nights without sleep is delirium. Delirium is typically a sudden change in mental status that can involve confusion, disorientation and difficulty with attention and memory. While insomnia is a contributing factor, it does not fully account for the acute cognitive changes the patient is experiencing. The symptoms described do not fully align with dementia or depression. In the context of recent severe sleep deprivation, the acute confusional state suggests delirium as the most accurate diagnosis.