Which sign should a nurse watch for in an older adult experiencing complications after a right knee replacement?

• A. Dry cough
• B. Acute confusion
• C. Increased temperature
• D. Purulent drainage from incision

Answer: (B)

In the context of an older adult who has undergone a right knee replacement, monitoring for acute confusion is particularly important. This symptom can be indicative of several serious complications, including infection, delirium, or adverse reactions to anesthesia or medications. Older adults are especially vulnerable to changes in mental status due to factors such as pre-existing cognitive impairments, the side effects of medications, or the stress of surgery.

Acute confusion can result from a range of post-surgical complications, and its presence may signal a need for immediate assessment and intervention. This can provide an opportunity for early detection of issues such as hypoxia, dehydration, or postoperative infections, which can be more challenging to identify in older populations compared to younger adults.

While other symptoms like increased temperature, a dry cough, or purulent drainage from the incision are also important to monitor as they could indicate potential complications (like infection), acute confusion stands out as a more critical and immediate sign that may require swift nursing intervention to assess the underlying cause and prevent further deterioration in the patient's condition.