Topic 11: Delirium

Question 1

Delirium

Answer 1

a state of confusion that develops over days to hours. Patient has a decreased ability to direct, focus, sustain, and shift attention and awareness. Deficits in memory orientation, language, visuospatial ability, or perception may be present

Question 2

Causes of delirium

Answer 2

· Dementia, dehydration
· Electrolyte imbalance, emotional stress
· Lung, liver, heart, kidney, brain
· Infection, intensive care unit
· Rx drugs
· Injury, immobility
· Untreated pain, unfamiliar environment
Metabolic disorders

Question 3

clinical manifestations of delirium

Answer 3

· Can range from hypoactivity and lethargy to hyperactivity, agitation, and hallucinations
· Develop over days to hours
· Inability to concentrate
· Disorganized thinking
· Irritability
· Insomnia
· Loss of appetite
· Restlessness
· Confusion
· Agitation
Misperception, misinterpretation, hallucination

Question 4

what is a reliable tool for assessing delirium

Answer 4

The Confusion Assessment Method (CAM)

Question 5

diagnostics for delirium

Answer 5

Potential causes need to be explored; this includes lab tests like CBC, serum electrolytes, BUN, creatinine, oxygen, urinalysis, drug and alcohol tests

Question 6

management for delirium

Answer 6

· Treatment of cause may reverse delirium
· Fluid and electrolyte imbalances and nutritional deficiencies are corrected if appropriate
· Antibiotic therapy should be started if there is an infection
· Protect patient from harm
· Provide calm and safe environment
· Encourage family to stay at bedside
· Provide familiar objects and photos at bedside
· Reorientation and behavioral interventions
· Reassurance
· Reduce environmental stimuli including light and noise
· Personal contact through touch
Avoid restraints