delirium Flashcards
1
Q
delrium
A
acute change in mental state
2
Q
key features delirium
A
disturbed consciousness, fluctuations - hypoactive (sleepy, withdrawn) then hyperactive (agitated, restless)
change in cognition - memory, perceptual, language, hallucinations
acute onset and fluctuant
3
Q
other features delirum
A
disturbance sleep-wake cycle
physical function - bad walking, falls
emotional disturbance - low mood, apathy
4
Q
what can percipitate delirium
A
infection dehydration biochemical disturbance pain drugs constipation, urinary disturbance sleep disturbance alcohol/drug withdrawal brain injury change environment, emotional distress
5
Q
why is delirium bad
A
morbidity + mortality inc risk death longer stay instututionalism functional decline
6
Q
diagnosing delirium
A
4AT - delirium screening tool
everyone 65+ admitted to hosp
7
Q
non-pharmacological Rx
A
- re-orientate and reassure
- early mobility, self care
- normalise sleepwake cycle
- avoid urinary catheterisation
8
Q
pharmacological Rx
A
only if danger to themselves or others, or distress which cannot be settled anyother way
usually not needed
sedation
oral quetiapine
9
Q
preventing delirium
A
orientation - glasses, hearing aids sleep hygeine early mobilisation pain control hydration, nutrition O2 if needed medication review
