Module 7: Delirium Flashcards
Delirium (del) vs Dementia (dem):
What are the onsets?
Del = Acute Dem = Insidious
Delirium vs Dementia:
What are the durations?
Del = Days to weeks Dem = Months to years
Delirium vs Dementia:
What does the course the disease look like?
Del = Fluctuating Dem = Slowly progressive
Delirium vs Dementia:
What does their consciousness look like?
Del = Impaired/fluctuating Dem = Clear until illness progresses
Delirium vs Dementia:
What does their memory/attention look like?
Del = inattentive, Poor memory without marked inattention Dem = Difficulty concentrating, memory intact minimally impaired until disease progresses
Delirium vs Dementia:
What id their affect?
Del = Variable Dem = Variable
Why are morning/baseline assessments extremely important for delirium?
Because if you know the patients norm, you will be able to identify whether or not this is an episode of delirium or something else
1/3 people have some degree of diagnosed dementia at __ years of age
85
What is dementia?
A gradual, progressive, irreversible disease that cause cognitive, social, and overall l/o Fx
What are some symptoms of dem?
know at least 4
- Memory loss
- Inability to learn or remember new information
- Difficulty with planning and organizing
- Difficulty with coordination & motor function
- Personality changes
- Inability to reason
- Incontinence
What are some more severe symptoms of dem?
know at least 4
- Disinhibition
- Poor insight/judgment
- Inappropriate behavior
- Aggression
- Repetitive behavior (wandering, calling out)
- Paranoia
- Agitation
- Hallucinations
- Difficulty communicating
What is receptive aphasia?
Inability to understand what is said
What is expressive aphasia?
Inability to express themselves verbally
What percent of elderly pts in the hospital will experience delirium?
Up to 60%
How many elderly in the hospital will die from their del?
Up to 33%
What is the prognosis for those who do survive? Why?
Poor d/t:
- Poor functional outcomes
- Higher institutionalization rates
- Increased risk of cognitive decline
- Higher mortality rates within following year
Describe del
An acute confusional state that is common, serious, often preventable, usually treatable
Criteria for del according to the DSM-IV
- Disturbance of consciousness (reduced clarity of awareness) with reduced ability to focus, sustain, or shift attention
- Change in cognition (memory, disorientation, language) or the development of a perceptual disturbance
- Disturbance develops over short time period, fluctuates
What are the 2 main presentations of del?
1) Hyperalert-hyperactive (15-47%)
2) Hypoactive-hypoalert (19-71%)
Can a pt present w both hyper and hypo?
Yes
What are some socio-demographic factors that put someone at a higher risk for del?
- Advanced age
- Male
- Residence in an institution
- Little contact with relatives
What are some mental status factors that put someone at a higher risk for del?
- Cognitive impairment (dementia)
- Depression
What are some medical problems and medsthat put someone at a higher risk for del?
- Severe medical illness
- Fracture on admission
- Polypharmacy
- Hypotension
- Fever
What are some physical factors that put someone at a higher risk for del?
- Vision and/or hearing impairment
- Functional impairments/disability
- Limited activity level
