A 58-year-old client is postoperative day 3 after right total knee arthroplasty. He has hypertension treated with amlodipine; preoperative BP was 132/80 and HR 78. He reports daily heavy alcohol use for 30 years, and his last drink was the morning of admission. Family reports no known withdrawal seizures or prior withdrawal delirium. Tonight he says insects are crawling on the wall and has tried twice to climb out of bed. He is oriented to person only, and attention drifts. Findings: BP 168/96 and HR 124, RR 22, T 38.2 C, and SpO2 95 percent on room air. He has a coarse hand tremor with diaphoresis. He rates knee pain 3/10 at rest and received oxycodone 5 mg 6 hours ago. There is swelling and bruising around the incision. This morning's hemoglobin is 11.2 g/dL, down from 13.0 before surgery.
一位58歲的個案在右膝關節置換術後第3天。他患有高血壓，以氨氯地平治療；術前血壓為132/80，心率為78。他報告每天大量飲酒30年，最後一次飲酒是在入院當天早上。家屬報告沒有已知的戒斷性癲癇發作或既往戒斷性瞻妄。今晚他說牆壁上有昆蟲在爬，並曾兩次試圖爬下床。他僅對人有定向感，且注意力不集中。發現：血壓168/96和心率124，呼吸頻率22，體溫38.2°C，以及室內空氣下血氧飽和度95%。他有粗顫合併出汗。他評估休息時膝蓋疼痛3/10，並在6小時前接受了5毫克羥考酮。切口周圍有腫脹和瘀傷。今天早上的血紅素是11.2 g/dL，低於術前的13.0。