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It's not always that simple. I had a Director of Nursing tell me one of his nursing home's elderly patients had begun hallucinating and they were sending councilors in to work with her. I asked the patient's charge nurse if the patient had started any new medications; or, changed dosage of an existing med. She said the patient had recently started on an antibiotic for a UTI. I convinced the DON to check with the pharmacist and the patient's doctor for an alternate antibiotic to conduct a drug challenge. The pharmacist said that while the incidence of side affects for the antibiotic in middle aged patients was negligible, he was getting reports of hallucinations in about 7% of the geriatric patients he served. The patient's doctor discontinued the first antibiotic and started the patient on an alternate one. Within 48 hours the hallucinations were gone.
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