Delerium Flashcards
1
Q
what is it?
A
a temporary disordered mental state, characterized by acute and sudden onset of cognitive impairment, disorientation, disturbance in attention, decline in level of consciousness or perceptual disturbance
2
Q
signs and symptoms
A
- Acute onset (develop within hours to days)
- Fluctuating course (may be drowsy, hypervigilant, agitated all within a short period)
- Poor attention (difficulty shifting or maintaining attention)
- Disorganized thinking (thoughts are not logical, difficult to follow)
- Altered level of consciousness
- Disorientation
- Memory impairment
- Day-night reversal (may also experience “sundowning” increased agitation in late afternoon or early evening)
- Psychomotor agitation or slowness
- Hallucinations (usually visual)
3
Q
3 types
A
- Hyperactive Delirium
• Agitation +/- aggressive behavior, increased psychomotor activity, psychosis and
mood lability
• Can lead to refusal of treatment, disruptive behavior and falls - Hypoactive Delirium
• More common in elderly
• Often missed because of the absence of disruptive behavior
• Withdrawal, apathy, lethargy, confusion
• Difficult to arouse and require strong stimuli (vigorous shaking, shouting) - Mixed Delirium
• Patients fluctuate btw the two types (hyperactive & hypoactive) in unpredictable patterns
4
Q
causes
A
- Infections
- Withdrawal (alcohol, sedative, hypnotics) • Acute metabolic
- Toxins, drugs
- CNS pathology
- Hypoxia
- Deficiencies (thiamine, B12)
- Endocrine
- Acute vascular
- Trauma (head injury, post-operative, falls) • Heavy metals
5
Q
OT prevention
A
- Encourage sleep/wake cycles
- Address lighting
- Constant cognitive assessments
- Strongly encourage early mobility
- Especially with mechanically ventilated patients
- Hearing aids, glasses, dentures
- Change of scenery
- Relaxing/familiar auditory stimulation
- Encourage out of bed for meals if appropriate
- Educate family about delirium and ways to assist
