In an older adult with confusion, hallucinations, and signs of dehydration, which management focus should the nurse anticipate to relieve the confusion and hallucinations?

• A. Fluid resuscitation to manage dehydration
• B. Initiating antipsychotic therapy
• C. Immediate endotracheal intubation
• D. Initiating a strict feeding schedule

Answer: (A)

Delirium with hallucinations in an older adult is often driven by reversible physiologic disturbances, and addressing the underlying issue is the priority. Dehydration reduces circulating volume and cerebral perfusion and can disrupt electrolytes, leading to confusion and perceptual disturbances. Restoring hydration helps reestablish brain perfusion and electrolyte balance, which commonly relieves the delirium and hallucinations. Plan for fluid resuscitation with IV or oral fluids as appropriate, and closely monitor urine output, vital signs, mental status, and labs (electrolytes, BUN/creatinine). Antipsychotics are not the first move because they don’t fix dehydration and can cause adverse effects in the elderly. Endotracheal intubation is unnecessary unless there’s an airway or respiratory failure, and a strict feeding schedule does not promptly address the dehydration driving the symptoms.