The nurse has reviewed the Nurses' Notes and Graphic Record for day three. Exhibits For each client finding, click to specify if the finding is consistent with delirium, dementia, or depression. Each finding may support more than one disease process.

Sudden onset: Sudden onset is most consistent with delirium, which begins abruptly over hours to days in response to acute illness or stressors such as infection. Dementia, by contrast, has a gradual, progressive course over months or years. Depression can develop relatively quickly, but not as abruptly or dramatically as seen in delirium. Wandering: Wandering can occur in both delirium and dementia. In delirium, it is often related to acute agitation and disorientation, whereas in dementia results from chronic confusion and impaired spatial awareness. Depression does not usually cause wandering; affected individuals are more likely to be withdrawn and inactive. Memory deficit: Memory impairment is seen in all three conditions. Delirium causes fluctuating, short-term memory issues that are reversible with treatment of the underlying cause. Dementia involves a progressive and irreversible decline in memory, particularly for recent events. Depression can mimic cognitive decline, but often improves with mood treatment. Sundowning: Sundowning, or worsening of symptoms in the late afternoon or evening, is common in both delirium and dementia. In delirium, this pattern is related to environmental stress and altered sleep-wake cycles. In dementia, particularly Alzheimer’s disease, sundowning is a frequent behavioral symptom. It is not typically associated with depression