Which symptom is a sign of postoperative delirium to monitor?

• A. Fluctuating consciousness, inattention, disorganized thinking.
• B. Persistent constant sleep.
• C. Normal cognitive function.
• D. Shortness of breath.

Answer: (A)

Postoperative delirium shows up as an acute brain dysfunction with changes in how the patient thinks and pays attention, and these changes tend to come and go over hours. The key signs are fluctuations in consciousness (level of alertness), marked inattention, and disorganized thinking. When you watch a patient after surgery, you’d look for someone who can drift from being alert and coherent to being confused or withdrawn, who has trouble focusing, following conversations, or answering questions in a logical way, and whose thinking seems scattered or rambling at times. This fluctuating, attention-deficit, and thinking-disorganization pattern is what sets delirium apart from normal postoperative sleepiness or fatigue.

Why the other options aren’t signs of delirium: persistent sleep alone isn’t delirium—sleepiness or sedation can occur after anesthesia but doesn’t capture the cognitive disturbance and variability that delirium shows. Normal cognitive function would indicate no delirium. Shortness of breath is a respiratory or cardiopulmonary symptom, not a cognitive or attentional disturbance.