Unit 5 - Delirium

Question 1

What is delirium? (2)

Answer 1

• a medical emergency
• sudden onset of cognitive disturbance (hours to days)

Question 2

What are the symptoms of delirium? (3)

Answer 2

• fluctuating symptoms
• change in LOC, attention, memory, perception
  remember that LOC does not change with dementia

Question 3

Why is delirium often missed with dementia? (3)

Answer 3

• delirium can be superimposed on dementia
• missed because increasing cognitive disturbances are identified as worsening dementia
• requires an interdisciplinary approach

Question 4

What is the prevalence of delirium? (2)

Answer 4

• 20% of older adults coming to emergency
• 90% of older adults in ICUS
• 40% of older adults in LTC

Question 5

What is delirium associated with? (2)

Answer 5

• increased risk for mortality and declines in function
• patients with dementia are less likely to be recognized for having delirium

Question 6

What are the causes of delirium? (6)

Answer 6

• medications (most common, drug toxicity, adverse effects)
• disease - infection (UTI, pneumonia)
• electrolyte imbalance
• pain related
• constipation
• environment (overstimulation, change in environment)

Question 7

How do we treat delirium?

Answer 7

treat the underlying (root) cause

Question 8

What are the consequences of not treating delirium? (4)

Answer 8

• Significant distress for person, family, and HCP
• associated with high morbidity and mortality, functional decline, increased postoperative complication
• increased length of hospital stay and hospital readmissions, increased services after discharge long term cognitive decline and high rates of institutionalization
• significant of older adults number never return to baseline cognition

Question 9

Why isn’t delirium recognized? (4)

Answer 9

• goes unrecognized in 34-90% in acute and LTC
• inadequate knowledge of condition
• inadequate knowledge of how to assess delirium
• lack of understanding between delirium and dementia

Question 10

What are the 3 types of delirium?

Answer 10

hyperactive, hypoactive, mixed

Question 11

What are the symptoms of hyperactive delirium? (5)

Answer 11

• agitation
• vigilance
• hallucinations
• restlessness
• hyperactivity

Question 12

What are the symptoms of hypoactive delirium? (3)

Answer 12

• most common
• lethargy
• decreased activity