CAM and 4AT Flashcards
1
Q
what 4 things are in the confusion assessment method for delerium?
A
1. acute onset+ fluctuating course AND 2. inattention AND 3. disorganised thinking OR 4.altered level of consciousness (drowsy/hyperative/agitated)
2
Q
what is in the 4AT assessment for delerium?
A
- alertness
- AMT4- age , DOB, place, current year
- attention- ask them to count the months backwards
- acute change or fluctuating course
3
Q
what is the total score in the 4AT test?`
A
12
but 4 or more= delerium
4
Q
what is delirium?
A
type of confusion
can often be caused by infection or shock and can last around a week
5
Q
can a catheter give you delirium
A
yes
6
Q
if they have delerium what should you make sure you do?
A
check bloods and correct U&Es and glucose make sure hydrated SEPTIC SCREEN ECG for MI or arrthymia stop drugs with neurotoxic effects relieve pain treat constipation think about alcohol withdrawel familiar staff avoid darkness use glasses and hearing aids avoid restraints orientation (clock , calanderm, photos) low noise level
7
Q
causes and risk factors for delerium
CHIMPS PHONED
A
constipation hypoxia infection metabolic disturbance pain sleepnessness prescriptions hypothermia/pyrexia organ dysfunction nutrition environmental changes drugs( over the counter, illicit, smoking)
8
Q
gold standard test for delerium?
A
4AT
9
Q
can lorazepam worsen delirium?
A
yes
10
Q
what does of haloperidol do you give?
A
0.25-0.5 mg
try giving orally first then can go IM
and if giving sedation you must document it and WHY!
