Delirium Flashcards
If a nurse comes up to you saying a patient has become agitated and she wants you to prescribe a sedative, should you?
NO
firstly go and assess the patient to identify any reversible causes of their agitation
what screening test can you do initially for delirium
4AT
when taking a history, what should you ask the patient as part of the systemic enquiry
go through the systems in order: CVS - chest pain resp - cough, SOB GI - pain, N+V, bowels GU - urine Neuro - focal deficit skin fever, weight loss, appetite
why is it important to take a drug history
to identify any new medications or any medications that have not been taken
what aspects of social history are important
alcohol - withdrawal? smoking - more prone to pneumonia and poor wound healing live alone recreational drugs occupational history driving
list some post-op complications
PE infection MI AKI ARDS / pulmonary oedema
if a patient has been in hospital for 2 days and is found to be hypothermic, what can this mean
sign of sepsis
cause of low BP
shock
causes of tachycardia
PE arrhythmia alcohol withdrawal pain shock
causes of tachypnoea
infection
PE
Pulmonary oedema
if a patient is agitated and is showing signs of infection, should you still bother with a neuro exam?
YES!
could be agitated due to a stroke, seizure, delirium tremens, wernicke/korsakoff…
if there is a problem with the heart, you would do a cardiac exam, same goes for the brain
rather be safe than sorry
what should you always do when treating delirium pharmacologically
DOCUMENT IT IN THE NOTES
5 big infections in the elderly
UTI
Resp tract - pneumonia
GI infection: E.coli, C.diff, campylobacter, diverticulitis, norovirus
Biliary - cholecystitis
Skin and soft tissue - cellulitis, ulcers…
why are the elderly more prone to resp tract infections
poor breathing technique aspiration poor oral hygiene immunocompromised poor reserve
where can you find Gm -ve bacteria
mouth - poorer oral hygiene
GI - aspiration
