Delirium

Question 1

What is delirium?

Answer 1

sudden onset symptom characterised by disturbed consciousness, cognitive function or perception

Question 2

What are the 2 types of acute delirium?

Answer 2

Hypoactive

Hyperactive

Question 3

Which type of delirium is more common in older people?

Answer 3

Hypoactive

Question 4

How is hypoactive delirium identified?

Answer 4

lethargy

excess somnolence

Question 5

How is hyperactive delirium identified?

Answer 5

agitated,

hallucinating

inappropriate

Question 6

What type of delirium might a patient who is agitated have?

Answer 6

hyperactive

Question 7

What type of delirium might a lethargic patient have?

Answer 7

hypoactive

Question 8

What type of delirium is moe likely to be missed?

Answer 8

hypoactive

Question 9

Without treatment, what is the likely outcome for a patient with delirium?

Answer 9

• Increased length of stay.

• Increased mortality (Hospital mortality rates of
patients with delirium are twice as high)
Hospital mortality: 22-76%
One-year mortality: 35-40%

• Increased risk of long-term care.

• Patients with delirium are also three times more
likely to develop dementia.

Question 10

What groups are most at risk of developing delirium?

Answer 10

Older people – the risk increases with age Age 65 and
above
• Older people taking multiple medicines.

• People with dementia.
• People who are dehydrated.
• People with an infection.
• Severely ill people.
• People who have had surgery, especially hip surgery.
• People who are nearing the end of their life.
• People with sight or hearing difficulties.
• People who have a temperature.
• Older people with constipation or urinary retention

Question 11

What can trigger delirium?

Answer 11

• Immobility
• Use of physical restraint
• Use of bladder catheter
• Pain
• Hypoxia
• Malnutrition
• Multiple medications

• Intercurrent illness
(infection/cardiac event etc)

• Dehydration or Constipation
• Sensory Impairment
• Sleep Disturbance

Question 12

What are the 3 most common triggers for delirium?

Answer 12

Hypoxia

Intercurrent illness

Dehydration or constipation

Question 13

What is delirium commonly mistaken for?

Answer 13

Dementia and Depression

Question 14

According to NICE, how many weeks maximum should sedative PRN medication should be kept on the drug chart?

Answer 14

1 week

Question 15

According to NICE guideline what sedation and dose shuld be given to a delirious patient?

Answer 15

Haloperidol lowest clinically appropriate dose