week 5- Delerium

Question 1

is confusion a normal part of ageing

Answer 1

no

Question 2

What are the main underlying causes for confusion in older people?

Answer 2

• Infection
• Hypoglycaemia
• Side effects of drugs
• Untreated pain
• Dehydration
• Hypoxia
• Anxiety, depression, psychosis
• Delirium
• Underlying pathophysiology: dementia

Question 3

What is the delirium mneumonic

Answer 3

Dehydration

Electrolyte imbalance – emotional stress

Lung, liver, heart, kidney, brain disorders

Infection, especially UTI, pneumonia, sepsis

Rx* drugs

Immobility

Untreated pain, unfamiliar environment

Metabolic disorders

Question 4

What is delirium commonly misdiagnosed with?

Answer 4

mood disorder
dementia

Question 5

What is excited delirium

Answer 5

The term “excited delirium” often used as a reason by police to restrain racialized groups and reported as cause of death in police custody

Question 6

What is the percetnage of older patients that get misdiagnosed with delerium?

Answer 6

Frequently unrecognized or misdiagnosed in up to 70% of older patients

Question 7

What are the three types of delirium?

Answer 7

Hyperactive
* Restless, agitated and aggressive
* They may hallucinate and removed tubes or fall out of bed

Hypoactive
* Inactive, withdrawn, quiet and sleepy

Mixed
* Fluctuate between hypo and hyperactive symptoms

Question 8

What drugs commonly induce delirium?

Answer 8

Drug induced delirium is most likely linked to benzodiazepines, opiates, anti- depressants and anticonvulsants

Question 9

what environment changes should be done to promote safety for someone with delirium?

Answer 9

• Simple and clear environment
• Adequate lighting
• Environmental cues to orient (clock, signs, calendar)
• Bring in familiar items from home
• Clear communication of names (badges and signs)
• Call bell is in reach
• Bed is in low position
• Consider use of bed rails (two side rails only)

Question 10

How can you orient patients experiencing hallucinations?

Answer 10

• Ensure use of hearing aid and eye glasses
• Orient the patient to person, place, and time, as needed
• Reintroduce him to health care providers with each contact
• Others: reduce sedation but control pain, do not validate hallucinations, remove excessive
  stimuli (eg TV)