A nurse is planning care for a client who has acute delirium. Which of the following instructions should the nurse include in the plan?

Choice A reason: Delirium, an acute confusional state, impairs orientation to time, place, and person. A calendar provides a visual cue to reinforce temporal orientation, reducing confusion and agitation. This non-pharmacological intervention supports cognitive grounding, helping stabilize the client’s mental status during acute delirium episodes. Choice B reason: Refuting hallucinations can increase agitation in delirium, as clients may feel invalidated. Hallucinations result from altered brain function, often due to metabolic or infectious causes. Acknowledging the client’s experience while redirecting focus is safer, as confrontation may escalate distress or confusion. Choice C reason: Teaching assertive techniques is inappropriate for delirium, as clients have impaired cognition and cannot process complex instructions. Assertiveness training is better suited for chronic mental health conditions like personality disorders, not acute delirium, which requires immediate stabilization of cognitive and physiological disturbances. Choice D reason: Assigning different caregivers each shift can worsen confusion in delirium, as consistency fosters familiarity and reduces anxiety. Delirium’s fluctuating cognitive state benefits from stable caregiving, which helps maintain a calm environment and supports recovery from underlying causes like infection or electrolyte imbalance.