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CP2 - HCOLL > Delirium > Flashcards

Delirium Flashcards

1
Q

What are the 4 key features of delirium

A

Disturbance of consciousness
Changes not better accounted for by pre-existing/evolving dementia
Develops over short p t + fluctuates
Hx underlying med condition/Dx withdrawal/intoxication

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2
Q

What % hospitalized patients have delirium?

A

30%

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3
Q

How much higher a risk are dementia patients at of developing delirium?

A

5-10x

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4
Q

Risk factors delirium (5)

A 
Dementia 
Multiple co-morbidities 
Physical fraility 
Older age
Sensory impairments
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5
Q

Precipitating factors delirium (8)

A 
Dx initiation 
Med illness 
Systemic infection 
Metabolic derangement 
Surgery 
Pain 
Brain disorders e.g. stroke 
Systemic organ failure
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6
Q

How is the diagnosis of delirium made?

A

AMT + CAM

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7
Q

When is CAM most sensitive + specific?

A

Acute onset + fluctuating course +
Innattention +
Disorganised thinking/altered level consciousness

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8
Q

What are the 3 types of delirium?

A

Hyperactive
Hypoactive
Mixed

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9
Q

DDx delirium (4)

A

Dementia
Focal neuro - Wernicke’s, frontal lobe lesion
Non-convulsive status epilepticus
1’ psych - depression/mania/schizo

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10
Q

Attention - Delirium vs Dementia

A

Delirium - distracted

Dementia - usually normal

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11
Q

Level of consciousness - Delirium vs Dementia

A

Delirium - Increased/unchanged/decreased

Dementia - usually norm

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12
Q

1st line Ix Delirium

A 
WCC/CRP
U+E
LFT
Glucose 
TFT
CHX
Urinalysis 
ECG
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13
Q

Mx delirium

A 
Tx underlying cause
Mx environment 
ABC observational approach 
Dx Mx 
Monitoring
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14
Q

Examples of how to manage a delirium patients environment (8)

A 
Involve family 
Soft lighting 
Clocks/calendars 
Sleep hygiene
Correct sensory impairment 
Keep mobile/active 
Avoid multiple rooms
Minimise provocation
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15
Q

Dx Mx Delirium

A

Haloperidol IM/PO

Lorazepam IM/PO

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16
Q

Indications for use of sedative Tx delirium

A

Agitated pt who = immeidate risk/harm

S term control distress

17
Q

Things to monitor whilst managing delirium pt (7)

A 
Vital signs 
Bowels 
Nutrition/hydration 
P areas 
Electrolytes 
Response to ABx 
Re-explore diagnosis if not improving
18
Q

Bedside assessment of Delirium

A

Confusion Assessment Method

19
Q

What are the 4 areas scored in the confusion assessment moethod?

A

1) acute onset + fluctuating course
2) inattention
3) disorganised thinking
4) altered level consciousness

20
Q

What % of pt never recover from a delirium ep

A

20%

21
Q

How much more likely are pt who have delirium to die within a year?

A

> 60%

CP2 - HCOLL (13 decks)

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