Elderly - Delirium Flashcards
1
Q
How does Delirium present?
A
Disturbed consciousness Change in cognition Acute onset Fluctuant Disturbance of sleep Disturbed physical behaviour Emotional disturbance
2
Q
What precipitates delirium?
A
Infection Dehydration Pain Biochemical disturbance Drugs Constipation/Urinary retention Hypoxia Drug withdrawal Sleep disturbance Brain injury Changes in environment
3
Q
How common in delirium?
A
20-30% of all inpatients
50% post-surgery
85% at end of life
4
Q
How is Delirium diagnosed?
A
4AT scoring
Patient assessment
5
Q
How do you manage Delirium?
A
Full history and examination
TIME bundle
Pharma/nonpharma
6
Q
What is the non-pharma management of Delirium?
A
Reassure agitated patient Encourage mobility and self care Normal sleep-cycle Ensure continuity of care Fix precipitating factor
7
Q
What is the pharma management of Delirium?
A
STOP bad drugs
Quetiapine if in severe distress
8
Q
What MDT would be indicated for Delirium?
A
Physio Nurse HCSW OT Pharmacisits Geriatrics Psychiatrists Social workers
9
Q
How is Delirium prevneted?
A
Glasses/hearing aids Early mobilisation Sleep hygiene Pain control Post-op care Hydration and nutrition Bladder + bowels
10
Q
What else must you consider in a patient with Delirium?
A
Capacity - who makes decisions for patient
11
Q
How are falls and Delirium linked?
A
Delirium increases fall risk x4.5
Delirium intervention = fall prevention
12
Q
How is UTI diagnosed in the elderly?
A
NOT DIPSTICK
MSSU urinalysis
