Delirium

Question 1

what are the causes of delirium? DELIRIUM

Answer 1

Drugs: opioids, sedatives, L-DOPA

􏰀 Eyes, ears and other sensory deficits

􏰀 Low O2 states: MI, stroke, PE

􏰀 Infection

􏰀 Retention: stool or urine

􏰀 Ictal

􏰀 Under- hydration / -nutrition

􏰀 Metabolic: DM, post-op, sodium, uraemia

􏰀 Subdural haemorrhage or other intracranial pathology

Question 2

what is delirium ?

Answer 2

Globally impaired cognition and impaired consciousness

Question 3

state some symptoms of delirium ?

Answer 3

restlessness
agitation
confusion
muddled

Question 4

what makes delirium different from dementia?

Answer 4

delirium is an acute episode (can come out of the blue) and is fluctuating (can be worse at night)

Question 5

state some tools that can be used to diagnose delirium ?

Answer 5

CRS - comprehensive ranking score 
MSQ - mental status questionnaire 
MMSE - mini mental state exam 
DRS - delirium ranking score 
CAM - confusion assessment score

Question 6

what are the three types of delirium?

Answer 6

hypoactive
hyperactive
mixed

Question 7

state some risk factors for delirium ?

Answer 7

age 
underlying cognitive impairment 
polypharmacy 
constipation 
alcohol excess 
immobility 
previous episodes

Question 8

what are three early signs of delirium ?

Answer 8

anxiety
sleep disorder
irritability

Question 9

is psychosis common in delirium ?

Answer 9

yes

Question 10

what are the four aims of delirium treatment?

Answer 10

reduce agitation
improve cognition
regulate sleep cycle
support family

Question 11

what are the two groups of medications used for delirium called?

Answer 11

anti psychotics

benzodiazepines

Question 12

what is terminal agitation ?

Answer 12

affects 40-85% of terminally ill
delirium with overwhelming anxiety

• EXCLUDE urinary retention