ICU Delirium

Question 1

what is delirium?

Answer 1

change in cognition and/or perception
alteration in LOC
inattention
abrupt onset(hrs/days)

Question 2

change in cognition and/or perception from delirium include?

Answer 2

Short-term memory, disorientation
Hallucinations: auditory or tactile
Not due to an underlying psychiatric condition
May have delusion, disorg speech, emotional lability, sleep-wake disturb.

Question 3

subtypes of ICU delirium include?

Answer 3

hyperactive
hypoactive
mixed

Question 4

hyperactive ICU delirium pts are

Answer 4

agitated
increased motor activity
makes up 1%

Question 5

hypoactive ICU delirium pts are

Answer 5

sleepy
inattentive
decreased motor activity
make up 44%

Question 6

Mixed ICU delirium makes up _____%

Answer 6

55%

Question 7

_____-____ of ICU pts develop delirium at any point and is frequently unrecognized or _______ by clinicians

Answer 7

20-80%

misdiagnosed

Question 8

onset is usually ICU day ____

Answer 8

2

Question 9

Duration is usually ____ days

Answer 9

4

Question 10

what does 4+ mean on the RASS?

Answer 10

combative

Question 11

what does 3+ mean on the RASS?

Answer 11

very agitated

Question 12

what does 2+ mean on the RASS?

Answer 12

agitated

Question 13

what does +1 mean on the RASS?

Answer 13

restless/anxious

Question 14

what does 0 mean on the RASS?

Answer 14

alert and calm

Question 15

what does -1 mean on the RASS?

Answer 15

drowsy (eyes open longer than 10 sec)

Question 16

what does -2 mean on the RASS?

Answer 16

light sedation (eyes open less than 10 secs)

Question 17

what does -3 mean on the RASS?

Answer 17

moderate sedation (no eye contact)

Question 18

what does -4 mean on the RASS?

Answer 18

deep sedation (respond only to physical stimulation)

Question 19

what does -5 mean on the RASS?

Answer 19

unarousable

Question 20

Delirium is independently associated with _____-____ times increased risk of death

Answer 20

2-13

Question 21

True or False

There is a correlation that the longer the duration of delirium the higher risk of long term cognitive impairment

Answer 21

true

Question 22

delirium increased length of stay in ICU from ____ to ___

Answer 22

5 days to 8 days

Question 23

delirium increased length of stay in hospital from ____ to ___

Answer 23

11 days to 21 days

Question 24

how is delirium managed?

Answer 24

sedation
improve sleep
early mobilization of pts

Question 25

True or False

For best delirium management with sedation, maximimze the excess use of benzodiazepines and narcotics

Answer 25

False

minimize

Question 26

True or False

Decreased sedation, improved sleep quality and early mobilization decrease delirium incidence

Answer 26

True