Confusion Flashcards
What is the definition of delirium?
Acute onset of confusion with a change in alertness
What are the CAM criteria for delirium?
Acute onset and fluctuating course
Inattention
Disorganised thinking
Altered level of consciousness
What is included in a 4AT assessment?
- Alertness (abnormal =4)
- AMT4 (1 mistake =1, 2 mistakes =2)
- Attention - name months backwards (less than 7=1, untestable =2)
- Acute/fluctuating? (Yes =4)
What is included in the AMT4 assessment?
Age, DOB, current year, location
What is the conservative management of delirium?
Reassurance and reorientation
Increased nursing supervision
When should 0.5mg oral haloperidol not be used?
Parkinson’s
Lewy body dementia
Use olanzapine
How can delirium be prevented?
Reorientation Familiar people Assess for dehydration and constipation Manage pain Medication review
What are the 7 steps of a medication review?
- Identify objectives of drugs
- Identify essential drugs
- Identify unnecessary drugs
- Check therapeutic objectives met
- Any ADRs?
- Is it cost effective?
- Is the patient willing and compliant?
What conditions may need less precise control in the elderly?
Hypertension - risk of hypotension
Diabetes - risk of hypoglycaemia
What is delirium (explanation)?
A state of mental confusion that can happen if you become medically unwell
What are the risk factors for delirium?
Over 65 years Cognitive impairment Dementia Current hip fracture Severe illness
