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Ageing > Delirium > Flashcards

Delirium Flashcards

1
Q

Define delirium.

A

Disturbance in attention
Change in cognition
Develops over a short period
Fluctuates

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2
Q

Who might you need to take a history from?

A

Family
Friends
GP
Carer

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3
Q

What is delirium associated with?

A 
Increased mortality
Longer hospital stay
Increased complications
Increased costs
Long-term disability
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4
Q

What does delirium represent?

A

An ‘atypical’ presentation of an acute illness

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5
Q

What does delirium increase the risk of for patients?

A

Longer hospital stay
DEMENTIA
Complications from hospital e.g falls, clots, pressure sores
Death

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6
Q

Onset?

A

Sudden - hours to days

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7
Q

Course?

A

Short and fluctuating

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8
Q

Reversible?

A

Yes

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9
Q

Duration?

A

Hours to less than months

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10
Q

Activity?

A

Hyperactive OR hypoactive

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11
Q

Alertness?

A

Fluctuates

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12
Q

Attention?

A

Impaired

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13
Q

Mood?

A

Fluctuating emotions

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14
Q

Thinking?

A

Disorganised

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15
Q

Perception?

A

Distorted

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16
Q

What might cause delirium?

A

Neurotransmitter fault (ACh)
Direct toxic insult (drugs, low O2, low Na, low glucose)
Decreasing stress hormone response

17
Q

Predisposing factors?

A 
Old
Dementia
Co-morbidity
Post-op (hip fractures)
Terminal illness
Polypharmacy
Depression
Alcohol
Malnutrition
Sensory Impairment
18
Q

Precipitating factors?

A 
Polypharmacy – strong painkillers, sedatives (e.g benzodiazepines), OPIATES
Hypoxia 
Low glucose or salt 
Dehydration 
Alcohol 
Infection
UTI
Environmental 
Catheters (foreign body)
Cardio e.g MI
Hip fracture
Urinary retention 
Constipation
19
Q

Hallmarks of delirium?

A

Acute and fluctuating
Inattention
Altered level of consciousness
Disorganised thinking

20
Q

What type of delirium is worse and why?

A

Hypoactive

More difficult to diagnose and higher mortality

21
Q

What tools are used to diagnose delirium?

A

4AT and CAM

22
Q

CAM

A 
1 + 2 + 3/4
Acute and fluctuating
Inattention
Altered level of consciousness
Disorganised thinking
23
Q

How is delirium managed?

A

DIAGNOSE
Find and reverse all causes
Support
Follow up

24
Q

How could you review a patient?

A

Redo 4AT to see if score has gone down

25
Q

The cause of delirium is always…

A

Multifactorial

26
Q

Name some environmental support.

A 
Sleep chart
Food and fluid chart
Mobilise as much as possible
Glasses and hearing aids
Review 
Buzzer
27
Q

When should you sedate a patient?

A

Only if they are a danger to themselves or others

28
Q

How is delirium prevented?

A 
Assess bowel and bladder function
Early mobilisation
Early nutrition
Hydration
Pain management
Sleep enhancement
29
Q

Name some medications for delirium

A

Haloperidol
Quitiapine (can use in Parkinson’s)
Benzodiazepines

Ageing (9 decks)

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