Delirium Flashcards
Abnormalities in attention is the hallmark of delirium. T/F?
True
How can delirium be distinguished from dementia?
Rapid onset, acute medical cause, impaired consciousness, major sleep-wake cycle disturbance, considerable fluctuations. 24 hour period, agitation, restlessness, more prominent visual hallucinations, prominent labile affect, distress
What is delirium?
A common acute neuropsychiatric syndrome of confusion
What are the hallmark features of delirium?
Impaired consciousness hyperactive or hypoactive subtypes acute onset change in cognition cognitive deficits visual hallucinations sleep-wake cycle disruption affect changes evidence of underlying direct cause in most cases
What precipitating factors can lead to delirium?
infection stroke MI drugs fractures cancer electrolyte/fluid imbalance heart failure diabetes PVD alcohol withdrawal
What are the non-pharmacological approaches to the treatment of delirium?
noise control and lighting control orienting influences fluid balance pain control regular communication and reassurance from staff limit variation in staff avoid ward transfer encourage normal sleep cycle consider necessity of certain procedures recognise fragility early mobilising
Antipsychotics are commonly used in the management of delirium. Which antipsychotics are used?
Laoperidol
olanzapine
risperidone
aripiprazole
Benzodiazepines are not commonly used in delirium other than when it is caused by…?
Alcohol withdrawal
Which benzodiazepines can be used in the treatment of delirium?
lorazepam
diazepam
Other than antipsyhcotics and benzodiazepines, what drugs can be used to treat delirium?
Melatonin
trazodone
What are the four diagnostic features of delirium?
A disturbance in attention
a change in cognition
acute presentation
evidence that disturbance has a direct medical underlying cause
What are the common predisposing factors for delirium?
older age dementia or cognitive impairment visual or hearing impairment functional imapirment history of delirium dehydration poly pharmacy co-existing medical illness physical frailty surgery
