A nurse is caring for a client who has rheumatoid arthritis and is experiencing difficulty feeding

B. A client attends to get out of bed and repeatedly states she must go home

Delirium is characterized by a change in cognition that occurs over a short period of time. It results from a secondary physiological condition (e.g., infection, surgery, prolonged hospitalization, hypoxia, fever, medications) and is a transient disorder. Although delirium can occur with any age, it is more common in older adults. It frequently progresses in the evening hours and is sometimes called "sundown syndrome." Delirium is characterized by alterations in memory, agitation, restlessness, illusions, or hallucinations. A client who becomes acutely confused and agitated may be showing manifestations of delirium.

c. Finger contractures

Scleroderma is a chronic disease that can cause thickening, hardening, or tightening of the skin, blood vessels, and internal organs. Manifestations include skin changes, Raynaud's phenomenon, arthritis, muscle weakness, and dryness of the mucous membranes. Contractures occur with advanced systemic scleroderma unless the client follows a regimen of range-of-motion and muscle-strengthening exercises, pain management, and joint protection.
- edema of the hands, fingers, and sometimes the lower extremities.
- will experience decreased salivation, which increases the risk of dental caries and gum disease.
- Thickening and hardening of the skin