COE neurp: Flashcards
Outline the common causes of delerium:
(PICHME - as in ‘I think I’m delirious - PINCH ME’)
P - Pain I - Infection N - Nutrition C - Constipation H - Hydration
M - Medication
E - Environment
What mental state examinations would you perform in those with delerium?
- AMT
- MMSE
What is a short CAM an what does it cover?
(short Confusion assessment method)
1) Acute onset/fluctuation
2) Inattention
3) Disorganised thinking
4) Altered consciousness
Give 4 features of delirium (OPAL):
- Orientation decrease
- Perceptions (hallucinations/delusions)
- Attention decrease
- Learning information decrease
What investigations would you form in someone with delirium?
- FBC, U&Es ect..
- CT head if ongoing
- Review of meds
Give the 4 principles of management of those with delirium:
1) Identify and treat the cause
2) Environmental supportive measures (good lighting, reality orientation)
3) Avoid sedation!!! if AP needed - LEVOMEPROMAZINE
4) Regular review and follow-up
What score on MMSE would cause you to think f mild dementia?
<26/30
What other mental state assessment can be used in dementia?
- (MMSE)
- GPCOG
- 6CIT
- MOCA
What is the management of Alzheimers?
Medication:
1) ACHEi: Rivastigmine, donepezil
2) NMDA-R blocker: memantine
Psycho:
- Group cognitive stimulation therapy
Social:
- Contact with family and friends
- activities in community
What should you never give in Lewy body dementia?
Antipsychotics
Give 4 causes of falls:
1) cardiac (arrhythmia)
2) Neurological (strokes)
3) Vasovagal, orthostatic
4) Intoxication (alcohol/pharm)
What investigations should be performed after a fall?
- GALS (? hip#)
- ECG (AF?)
- BP lying and standing (orthostatic hypotension?)
- Urine dip (UTI?)
What assessment tool are used to assess falls risk?
FRAT - Falls Risk assessment too;
MFS - Morse fall scale
What should one perform if someone has history of falls?
Gait and balance assessment
What score denotes the risk of fractures?
FRAX - risk of osteoporosis related fracture in the next 10years (40-90y/o)
What interventions can be performed to help prevent falls?
- Strength and balance training
- Home hazard assessment
- Visual assessment
- Medication review
- Cardiac pacing
What can be done to prevent falls in hospitals?
- Adequate flooring
- Furniture
- Walking space
- Lighting
