A very common cause of confusion which deteriorates to hallucinations is sodium imbalance. I could be way off base here but given that Linda was diagnosed with hydration on admission, then maybe her sodium levels are off. Simple blood test will see.

Also, I didn't know about heparin causing confusion but nicotine patches certainly can, and withdrawal from smoking (even with the patches)can cause irritability which may be manifesting as paranoia and violence. But do one thing at a time so if Linda improves, you will know what has done it, so you know what to avoid in future.

I personally struggle with the idea of giving her an antipsychotic if she isn't psychotic too - but I am not a doctor. Can you get another opinion from elsewhere?