Which delirium prevention strategy is appropriate on admission?

• A. Administer benzodiazepines for agitation.
• B. Early mobilization and orientation/sleep hygiene.
• C. Avoid hydration.
• D. Keep patient in isolation.

Answer: (B)

Focusing on nonpharmacologic prevention right at admission is key. The best approach combines getting the patient moving as tolerated with strong orientation and sleep routines. Early mobilization helps prevent delirium by reducing deconditioning, improving circulation and cerebral oxygenation, and supporting overall metabolic stability. Pairing that with consistent orientation cues—like clocks, calendars, familiar cues, and regular staff interaction—and strong sleep hygiene (minimizing nighttime awakenings, reducing noise and bright light at night, promoting daytime activity) helps stabilize the patient’s cognitive environment and supports a normal sleep–wake cycle. Together, these strategies address common contributors to delirium, such as immobility, disorientation, and disturbed sleep.

Benzodiazepines are not appropriate for delirium prevention and can worsen delirium in many patients, particularly older adults, so they’re not part of a preventative plan. Deliberately avoiding hydration is harmful because dehydration is a known delirium risk factor; maintaining adequate fluids is important. Keeping the patient in isolation is not a preventive delirium strategy and can contribute to sensory deprivation and delirium risk, unless isolation is medically necessary for infection control.