Chapter 15 Part 1: Delirium

Question 1

What is delirium

Answer 1

characterized by impaired consciousness and cognition during the course of several hours or days, often appearing condused, disoreiented and out of touch wiht their surroundings, with marked impairments in memory and language.

Question 2

prevalence of delirium in people over the age of 65

Answer 2

10%

Question 3

common risk factors for delirium in older patients

Answer 3

the presence of other neurocognitive disorders like dementia, medication, or physical medical illness

Question 4

What type of medication is often associated with causing delirium

Answer 4

anticholinergic medications. Those used to counteract extrapyramidal side effects of neuroleptic medications.

Question 5

environmental factors in older adults that may cause delirium

Answer 5

environmental changes like room chnages, absence of clocks, watches or reading classes were related to an increase in delirium severity over time.

Question 6

fMRI scanning has shown that delirium is associated with lasting disruption of connectivity between ___ ____ cortex and ___ ____ cortex, and reversible disruptions between the ____ and the ___ ___ system.

Answer 6

fMRI scanning has shown that delirium is associated with lasting disruption of connectivity between DORSOLATERAL PREFRONTAL cortex and POSTERIOR CINGULATE cortex, and reversible disruptions between the THALAMUS and the RETICULAR ACTIVATING system.

Question 7

first step for the treatment of delirium

Answer 7

addressing underlying causes. Ex/ is this due to drug use? the use of medication? other medical conditions? Infection?

Question 8

What kind of drugs are prescribed fro delirium when the cause of delirium is not yet known?

Answer 8

antipsychotics like haloperidol or olanzapine.

Question 9

psychosocial treatments for delirium

Answer 9

• making sure the pt is involved in his care (ie/ has a say in treatment decisions)
• adding familiar personal belongings like photographs.

Question 10

prevention strategies for delirium

Answer 10

broad spectrium of intervnetions including education, support, reorientation, and anxiety reduction may be effective in preventing delirium in surgical patients at risk for delirium

requires an interdisciplinary team to work on increasing sleep and physical activity, maintaining proper hydration and nutrition, involving the pt in therapeutic activities, and reducing dosages of psychoactive drugs.