Delirium Flashcards

1
Q

what is delirium?

A

an acute change in mental state

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2
Q

What are the signs of hyperactive delirium?

A
Agitated 
aggressive
incoherent speech 
disorganised thoughts
delusion 
hallucinations
disorientation
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3
Q

what are the signs of hypoactive delirium?

A

sluggish
drowsy
withdrawn
less reactive

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4
Q

which type of delirium might a patient get?

A

A patient can swing between having hyperactive AND hypoactive delirium.

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5
Q

what symptom is common in both types of delirium?

A

Sleepiness.
disturbed psychomotor behaviour
emotional disturbance

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6
Q

what is the difference between dementia and delirium?

A
Dementia:
- comes on over months/years.
- don't have hallucinations
delirium:
 - sudden onset.
- can have hallucinations
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7
Q

what are the risk factors of delirium?

A
  • surgery
  • lack of sleep
  • pneumonia
  • UTI
  • previous delirium
  • consipation
  • opiates
  • extremes of age (old most common, can still get in young).
  • frailty
  • dehydration
  • pain
  • hypoxia
  • alcohol/drug withdrawal
  • changes in environment
  • emotional distress
  • stroke/tumour/bleed
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8
Q

how much more likely is someone with delirium at risk of a fall?

A

up to 6X more likely to fall.

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9
Q

how much more likely is someone with delirium at risk of a fall?

A

up to 6X more likely to fall.

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10
Q

when is delirium worst?

A

Often worse at night.

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11
Q

how common is delirium?

A

Commonest hospital complication

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12
Q

how much percentage of people get

A
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13
Q

what percentage of people develop delirium in hospital?

A
  • 20-30% of all in patients
  • up to 50% of post surgery people
  • up to 85% at end of life
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13
Q

what percentage of people develop delirium in hospital?

A
  • 20-30% of all in patients
  • up to 50% of post surgery people
  • up to 85% at end of life
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14
Q

Which test is done to assess delirium?

A

4AT test

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15
Q

who should be tested for delirium?

A

Anyone who is admitted to hospital >65yrs.

16
Q

which questions are asked in the 4AT test?

A
LADY
Location
Age
Date of birth
Year
17
Q

what is the treatment for delirium?

A

Mainly non-pharmacological:

  • re orientate
  • encourage mobility and self care
  • give hearing aids and glasses if they have
  • normalise sleeping pattern
  • try to treat at home as much as possible
  • discharge from hospital ASAP
  • avoid medical procedures - eg catheterisation
18
Q

what is the pharmacological management of delirium?

A

stop bad drugs

drugs for delirium are not usually necessary

19
Q

Which medication can be given as a last resort?

A

Quetiapine

20
Q

how much delirium is preventable?

A

30%

21
Q

what are people more likely to develop after having delirium?

A

another episode of delirium
dementia
other frailty syndromes

22
Q

what should not be done for UTI in older people?

A

should NOT be diagnosed using urine dipstick - often come up positive.