The nurse has reviewed the Nurses' Notes and Graphic Record for day three. Exhibits Select the 3 client manifestations that the nurse should prioritize when planning care.

A. Altered sleep-wake cycle: An altered sleep-wake cycle is common in older adults, particularly those in unfamiliar hospital settings. While it may contribute to delirium, it is not as immediately dangerous as confusion, wandering, or speech impairment. B. Wandering: Wandering poses an immediate safety risk, especially in a confused and unstable elderly patient. This behavior increases the likelihood of falls, dislodgement of medical devices (e.g., oxygen), and unintentional exit from safe environments. C. Confusion: Confusion is a priority concern because it represents a sudden change in mental status and may indicate acute delirium, often related to infection, hypoxia, or metabolic imbalance. In this client, it could be a sign of worsening pneumonia or sepsis. Left unaddressed, it increases risk for injury and decline in overall status. D. Memory deficits: Memory loss is concerning but not as urgent. Memory deficits can be chronic and may be baseline for the client. Unlike sudden confusion or wandering, memory loss alone does not pose an immediate threat to safety. E. Incoherent speech: Incoherent speech reflects impaired cognition and is often a sign of acute delirium. It suggests that the client is unable to effectively communicate needs, which can compromise safety, hydration, and medication compliance. Prompt attention is required to evaluate underlying causes and protect the client from harm.