Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

SENIORS HEALTH > Delirium > Flashcards

Delirium Flashcards

0
Q

What is delirium?

A 
** medical emergency
Syndrome characterized by:
1. Acute onset
2. Fluctuating course
3. Disturbances in:
- thought
- memory 
- attention**
- behaviour
- perception (hallucinations)
- orientation 
- consciousness 
- speech (disorganized, unclear)
** unidentifiable underlying medical cause
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

What are the three behavioural subtypes of delirium?

A
  1. Hypoactive
  2. Hyperactive
  3. Mixed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is delirium?

A 
** medical emergency
Syndrome characterized by:
1. Acute onset
2. Fluctuating course
3. Disturbances in:
- thought
- memory 
- attention**
- behaviour
- perception (hallucinations)
- orientation (person, place, time)
- consciousness 
- speech (disorganized, unclear)
** unidentifiable underlying medical cause
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the characteristics of hypoactive delirium?

A
  • slowed movement
  • paucity of speech
  • non responsiveness

*more unnoticed .. May lead to death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Development and duration of delirium

A
  • Delirium develops over a short period of time (hours or days)
  • Can fluctuate over the course of the day, usually affecting sleep and wake cycle
  • can persist over months
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Prevalence of delirium

A

Critically ill older adults have an 80% rate

Long term care 70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What can you give postoperatively to prevent delirium?

A

Anitcholinergics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Risk factors for long term care residents to have delirium

A 
Dementia
Functional dependency 
Pain
Depression
Behavioural disturbances 
Number of medications 
Dehydration
Malnutrition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Common factors increase risk of delirium

A 
INFECTION: watch for atypical presentation
Advanced age
Pain
Dementia
Surgery: general anesthetic 
Medications psychological disturbances (change to meds)
Pathological conditions 
Impaired functioning 
Cognitive status 
alcohol
prolonged sleep deprivation
Environment: change, admit to ICU
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Nursing assessment for delirium

A
  • frequent assessment and monitoring of mental assessment
  • CAM
  • Past medical history, including any psychiatric history
  • Current medications
  • Family history
  • ***Pre episode cognitive and functional status
  • Assess for any significant events (such as
    falls, injury, changes in diet, medications,
    etc)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Nursing assessment for delirium

A
  • frequent assessment and monitoring of mental assessment
  • CAM
  • I WATCH DEATH
  • Past medical history, including any psychiatric history
  • Current medications
  • Family history
  • ***Pre episode cognitive and functional status
  • Assess for any significant events (such as
    falls, injury, changes in diet, medications,
    etc)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What assessment tool is used for delirium?

A

The Confusion Assessment Model (CAM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the CAM assessment?

A
  1. ACUTE ONSET AND FLUCTUATING COURSE- is there evidence of acute change in mental status from baseline or abnormal behaviour that tends to come and go or increase or decrease
  2. INATTENTION: does the patient have difficulty focusing or keeping track of what is being said? Are they easily distracted?
  3. DISORGANIZED THINKING: is the patient’s thinking or conversations coherent, disorganized or illogical? Do they switch topics?
  4. ALTERED LEVEL OF CONSCIOUSNESS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Nursing interventions for delirium?

A
  • requires multidisciplinary approach **
    Some
    1. Provision for aids to orientation (clocks, callenders)
    2. Aids for sensory function (glasses, hearing aids)
    3. Frequent verbal orientation
    4. Environment modifications (noise reduction)
    5. Identify adverse medications
    6. Adequate pain management
    7. Social support
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What nursing interventions can be done for acute confusion?

A
  1. Anxiety reduction
  2. Behaviour reduction
  3. Cognitive stimulation
  4. Delirium management
  5. Energy management
  6. Environment management
  7. Fluid/electrolyte management
  8. Hallucination management
  9. Medication management
  10. Mood management
  11. Pain management
  12. Reality orientation **
  13. Sedation management
  14. Surveillance: safety
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how does the hospital affect delirium?

A
    • best place for delirius patient, solve the issue, or safety issues
      1. can develop delirium in hospital
      2. surgeries can cause it
      3. after hip frac or surgery 40% become delirium
16
Q

how do you deal with a delirious patient in hospital?

A
    • find underlying cause
      1. private room near nursing desk
      2. have news papers, calenders and clocks
      3. reorientate
      4. introduce yourself
      5. be calming and reasuring
      6. get rid of distractions
      7. helps with ADLs
      8. dont argue with their delusions
      9. dont use foley caths, because they will pull it out, do in and outs
      10. ambulate patient
17
Q

delirium stats

A
  1. 4 times more common in old people
  2. 15% in acute setting
  3. 20% develop in acute care setting
  4. 40-60% of residents in lodges will
  5. previous delirium = 90% chance it will happen again
19
Q

what can a caregiver do for a delirious person

A
  1. safe environment
  2. make sure hearing aids, or glasses are on them
  3. promote healthy eating
  4. encourage safe activity
20
Q

recommended lab tests

A
  • CBC
  • B12
  • Folate
  • TSH
  • FBG
  • Bun/Creatinine
  • Electrolytes
  • Drug Levels
  • Ca/PO4
21
Q

I WATCH DEATH

A

INFECTION (encephalitis, meningitis, UTI, pneumonia)
WITHDRAWL l (alcohol, barbiturates, benzodiazepines)
ACUTE METABOLIC DISORDER (electrolyte imbalance, hepatic or renal failure)
TRAUMA (head injury, postoperative)
CNS PATHOLOGY (stroke, hemorrhage, tumour, seizure disorder, Parkinson’s)
HYPOXIA (anemia, cardiac failure, pulmonary embolus)
DEFICIENCIES (vitamin B 12 , folic acid, thiamine)
ENDOCHRINOPATHIES (thyroid, glucose, parathyroid, adrenal)
ACUTE VASCULAR (shock, vasculitis, hypertensive encephalopathy)
TOXINS, SUBSTANCE USE, MEDICATIONS (alcohol, anesthetics, anticholinergics, narcotics)
HEAVY METALS (arsenic, lead, mercury)

22
Q

Related labs for related medical issues.

A 
 CBC
 B12
 Folate
 TSH
 FBG
 Bun/Creatinine
 Electrolytes
 Drug Levels
 Ca/PO4
23
Q

lab tests to diagnose delirium

A 
 ESR
 Cortisol Level
 LFT 
 Chest X-Ray
 ECG
 O2 Saturation
 CT Scan
 Urinalysis
 VDRL
24
Q

treating deliruim

A

–> Pharmacological Interventions
Eg. Antipsychotics, Benzodiazepines
–> Non-Pharmacological** first line
- Assess safety
- Address modifiable risk factors- decrease sensory
deficits, address pain, sleep
- Modify the environment- minimize noise, keep
sensory stimulus minimal, provide a familiar
environment, ensure that there is appropriate
level of lighting
- COMMUNICATE, COMMUNICATE, COMMUNICATE!

SENIORS HEALTH (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions