Delerium Flashcards
1. Understand the clinical definition, symptoms, and features of delirium. 2. Understand the medical factors that lead to delirium in vulnerable patients 3. Outline strategies for managing delirium
def of delilirum
acute change in mental status, charecterized by waxing and waning course, attributable to medical factors
sx of delirium
altered conciousness, reduced abilityto focus, sustain, or shift attention
medical conditions that can commonly cause delirium
cancer, elderly, CABG, AIDS, terminal illness, hip surgery
signs of delirium
disorientation, lapses in memory, confusion, hyper/hypo active motor function, reduced comprehension, aphasia, sleep disturbances, dysphoria, hallucinations, delusions, attention difficulty
major differene between dementia and delurium
delerium waxes and wanes
ddx of delirium
infection withdrawal acute metabolic issue trauma CNS pathology Hypoxia defieciencies endocrinopathies acute vascular toxins heavy metal poisoning
risk factors for delirium
age, dementia, CNS injury, medical problems, multiple meds, low serum albumin, drug use, sleep deprivation, sensory impairment, immobilization
biggest risk factor for delirium
age
work-up for delirium
review HX for change from baseline
PE (neuro)
cognitive testing
review meds
drugs that can cause delirium from withdrawal
opiates
benzos
EtOH
drugs that can cause delirium from use
anticholinergics
ex anticholenergic drugs
diphenhydramine amitrtiptyline cimetidine rantidine digoxin furosemide nifedipine prednisolone promethazoine theophylline
general strategies for treating delirium
identify and treat underlying cause make sure the area is safe facilitate reality make sure glasses and hearing aids are being used modulate sensory stimulation (no TV)
drugs for delirium
Haloperidol, atypical antipsychotics
drug to avoid in treating delirium
benzos