Psychiatry of physical condition Flashcards
What is Delirium?
Impaired consciousness and perception - acute
What percentage of Delirium cases are missed or miss diagnosed?
32-67% missed
Main points for diagnosing delirium
Impaired consciousness Disturbance of cognition Psychomotor disturbances Sleep disturbance Emotional disturbances
Describe the impaired consciousness associated with delirium.
Clouded
Distracted
Drowsiness
Often worse at night
Disturbances of cognition in delirium.
Loss of time and place
Impaired memory and attention
Hallucination
Delusion
Disturbance of sleep in delirium
Insomnia
Sleep loss
Nocturnal worsening of symptoms
Emotional disturbances in delirium
Anxiety Fear Apathy Perplexion Euphoria Irratibility
What are some general symptoms of delirium?
Rapid onset
Transient and fluctuating
Last days to months
Hallucinations are generally visual
What are some risk factors for Delirium?
Age Cognitive deficits Dementia Previous episodes Perioperatives Hypo/hyperthermia Sensory deficits New environment
What bloods are taken in a suspected delirium?
UE
FBC
Foliate
B12
What is the management of delirium?
Treat underlying cause then manage their surroundings and treat if they become very agitated
How can you manage the environment in a patient with delirium?
Reality orientation - calendar and a clock
Clear communication
Bright side room and minimise unnecessary noice
What antipsychotic can be used in delirium?
Haloperidol 1-10mg
0.5mg in elderly
A patient with a hyperactive psychomotor disturbance due to delirium will present with.
Recent injury Sudden onset agitation and restlessness Fine during day overactive during the night Disruptive behaviour Persecutory delusions and hallucinations
A patient with hypoactive psychomotor disturbances due to delirium will present with?
Sudden withdrawal sleepiness and tiredness
Lack of self care
Appear depressed
Unmotivated
Uncooperative or engaging in rehabilitation
