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NSB236 > Week 4 - Delirium > Flashcards

Week 4 - Delirium Flashcards

1
Q

Delirium is characterised by what behaviours?

A

Hypoalert-hypoactive and hyperalert-hyperactive.

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2
Q

What is hypoalert-hypoactive?

A
  • Slowed psychomotor function
  • Lethargic
  • Confused
  • Sedated
  • Reduced awareness
  • Poor attention span
  • Drowsy
  • Withdrawn
  • Apathetic
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3
Q

What is hyperalert-hyperactive?

A
  • Restless
  • Agitated
  • Confused
  • Suffer hallucinations and delusions
  • Paranoia
  • Disorientation
  • Pulling at invasive lines or monitoring equipment
  • Aggressive
  • Combative
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4
Q

What is agnosia?

A

Inability to process sensory information.

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5
Q

What is apraxia?

A

Loss of the ability to execute or carry out learned purposeful movements.

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6
Q

What is aphasia?

A

Inability to comprehend and formulate language.

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7
Q

What are the predisposing conditions that can lead to delirium?

A
  • > 60 years
  • Male
  • Visual impairment
  • Underlying brain pathology
  • Major medical illness
  • Recent major surgery
  • Depression
  • Functional dependence
  • Dehydration
  • Substance abuse
  • Hip fracture
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8
Q

Confusion assessment method:

A

Positive CAM result:

  1. Presence of acute onset and fluctuating course
  2. Inattention
  3. Altered LOC
  4. Disorganised thought process
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9
Q

What is delirium?

A

Acute disorder of attention whereby a person’s mental ability is affected.

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10
Q

Delirium behaviours:

A
  • Acute onset
  • Inattention
  • Anterograde amnesia
  • Disorientated
  • Illusions
  • Hallucinations
  • Impaired reasoning
  • Depressive
  • Fearful
  • Agitated
  • Resolves quickly
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11
Q

Dementia behaviours:

A
  • Insidious
  • Delusions
  • Amnesia
  • Agnosia
  • Apraxia
  • Aphasia
  • Irreversible
  • Frontal release signs
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12
Q

Precipitating factors leading to delirium:

A
  • Medications
  • Severe acute illness
  • UTI
  • Hypoxemia
  • Shock
  • Anaemia
  • Pain
  • Orthopedic surgery
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13
Q

Delirium tremens:

A
  • Rapid onset usually caused by alcohol withdrawal
  • Typically occurs within 1-3 days into withdrawal
  • Symptoms usually last 2-3 days
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14
Q

Benzodiazepine:

A
  • Delirium - contraindicated

* Delirium tremens - indicated

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15
Q

Confusion assessment method:

A
  1. Presence of acute onset and fluctuating course; AND
  2. Inattention; PLUS EITHER
  3. Disorganised thought process; OR
  4. Altered LOC
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16
Q

D.E.L.I.R.I.U.M

A 
D = drugs
E = ears and eyes (reduced sensory input)
L = lack of drugs; low O2 sats
I = infection (UTI)
R = retention of urine or faeces 
I = intracranial (infection)
U = under-hydration and under-nutrition
M = metabolic
17
Q

First-line pharmacological intervention:

A

Haloperidol = antipsychotic

18
Q

Nursing interventions for delirium:

A

Frequent interaction and support.

NSB236 (5 decks)

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