A nurse in an emergency department is assessing a client who was brought in by a caregiver. The caregiver reports that the client has had a change in behavior over the past 2 days. The nurse should identify which of the following findings as an indication that the client has delirium? Select all that apply.

Choice A reason: Aphasia, or difficulty with language, can occur in delirium due to acute disruption of cognitive processing. Clients may suddenly struggle to find words, understand speech, or communicate effectively. This is consistent with delirium’s hallmark of acute cognitive disturbance. Choice B reason: Hallucinations are common in delirium, especially visual hallucinations. They result from acute brain dysfunction and fluctuating consciousness. Hallucinations are a key differentiating feature from dementia, which progresses gradually and is less likely to cause vivid perceptual disturbances in the early stages. Choice C reason: Akathisia is a movement disorder characterized by inner restlessness and the inability to stay still, often caused by antipsychotic medications. While it may coexist in psychiatric clients, it is not a defining feature of delirium. Therefore, it is not an indicator of delirium. Choice D reason: Change in level of consciousness is a hallmark of delirium. Clients may fluctuate between hyperalertness and lethargy, often within hours. This acute alteration distinguishes delirium from chronic cognitive disorders such as dementia. Choice E reason: Decreased attention span is a core diagnostic feature of delirium. Clients are unable to focus, sustain, or shift attention appropriately. This impairment is often the earliest sign noticed by caregivers and clinicians.