delirium Flashcards
Delirium
is a state of confusion that develops over days to hours.
reversible and acute
Problems that accompany delirium
Deficits in memory, orientation, language, visuospatial ability, or perception may be present. The patient may be hypoactive or hyperactive. Emotional problems include fear, depression, euphoria, or perplexity. Sleep may be disturbed.
Causes of delirium
impaired cerebral oxidative metabolism
the brain gets less oxygen and has problems using it.
Causes of delirium (Mnemonic)
D-ementia, dehydration
E-lectrolyte imbalances, emotional stress
L-ung, liver, heart, kidney, brain
I-nfection, intensive care unit
R-x drugs
Injury, immobility
U-ntreated pain, unfamiliar environment
M-etabolic disorders
Facts about Delirium
-most often occurs among hospitalized older adults
-it is the most common surgical complication among older adults
-may be the first symptom of life-threatening problems such as pneumonia, urosepsis, or meningitis.
Manifestations of delirium
ranging from hypoactivity and lethargy to hyperactivity, agitation, and hallucinations.
Memory, judgment, and orientation are impaired.
Speech is rapid, rambling, and/or incoherent.
Other manifestations often include disorganized thinking, irritability, insomnia, loss of appetite, and restlessness.
Later manifestations may include agitation, misperception, misinterpretation, and hallucinations.
Diagnostic Studies
Confusion Assessment Method (CAM)
Laboratory tests include CBC, serum electrolytes, blood urea nitrogen (BUN), and creatinine levels; ECG; urinalysis; liver and thyroid function tests; and O2 saturation.
Drug and alcohol levels
If unexplained fever or nuchal rigidity is present and meningitis or encephalitis is suspected, a lumbar puncture may be done
CSF is examined for glucose, protein, and bacteria. If the patient’s history includes head injury, appropriate x-rays or scans may be ordered. In general, brain imaging studies, such as CT and MRI, are used only when head injury is known or suspected.
