Delerium

Question 1

What are the key features of delirium?

Answer 1

• Disturbed consciousness (Hypoactive, Hyperactive, Mixed)
• Change in cognition (Memory, Perceptual, Language, Illusions, Hallucinations)
• Acute onset and fluctuant
• Disturbance of sleep-wake cycle
• Disturbed psychomotor behaviour
• Emotional disturbance

These features help in identifying and diagnosing delirium in patients.

Question 2

Name three risk factors for delirium.

Answer 2

• Infection (e.g. UTI)
• Dehydration
• Biochemical disturbance

Other factors include pain, drugs, constipation, urinary retention, hypoxia, alcohol or drug withdrawal, sleep disturbance, and brain injury.

Question 3

What is the 4AT Score used for?

Answer 3

Assessment of delirium

The 4AT Score includes Alertness, AMT4 (Abbreviated Mental Test), Attention, and Acute change.

Question 4

True or False: Dipstick tests are recommended for diagnosing UTI in older people.

Answer 4

False

Dipstick tests should not be used for diagnosing UTI in individuals over 65 years.

Question 5

What approach should be taken for managing delirium?

Answer 5

• Treatment of the cause
• Explain the diagnosis
• Pharma and Non-Pharma measures

The management includes a full history and examination as part of the treatment.

Question 6

Fill in the blank: Non-pharmacological treatment of delirium includes _______.

Answer 6

[key learning term]

Non-pharmacological treatment includes re-orientation and reassurance, early mobility and self-care, correction of sensory impairment, normalizing sleep-wake cycle, ensuring continuity of care, avoiding urinary catheterization/venflons, and discharging patients as soon as possible.

Question 7

What is a key pharmacological treatment approach for delirium?

Answer 7

STOP BAD DRUGS (medication review)

There is no evidence that medical treatment improves outcomes, but medications may be used if the patient poses a danger to themselves or others.

Question 8

What is the prevalence of asymptomatic bacteriuria in the elderly?

Answer 8

Very high

It is so high that urine culture ceases to be a diagnostic test in this population.

Question 9

What should be ensured in the management of delirium?

Answer 9

• Continuity of care
• Early mobility
• Correction of sensory impairment
• Normalization of sleep-wake cycle

These factors are important for effective management and recovery from delirium.

Question 10

What is the purpose of the TIME bundle in delirium management?

Answer 10

To treat the cause of delirium

The TIME bundle includes interventions aimed at addressing the underlying factors contributing to delirium.