Delirium Flashcards Preview

Y3 AGEING > Delirium > Flashcards

Flashcards in Delirium Deck (16)
Loading flashcards...
1

Define delirium

Disturbance in attention
Change in cognition
Developing over a short period
Fluctuating course

2

Compare the onset of delirium with dementia

Dementia: chronic, slow
Delirium: acute, sudden

3

Compare the course of delirium with dementia

Dementia: progressive, irreversible
Delirium: fluctuating, reversible

4

List some symptoms of delirium

Agitation, restless (hyperactive)
Slow, sleepy (hypoactive)
Fluctuating emotions
Impaired attention

5

List predisposing factors for getting delirium

Old age
Sensory impairment
Polypharmacy
Dementia, depression
Alcohol dependency
Malnutrition
Post-op (typically hip fracture)

6

Hypoactive delirium has twice the mortality of hyperactive delirium. True/False?

True

7

Describe the 4AT tool for diagnosing delirium

Alertness (name and address)
AMT4 (age, dob, place, year)
Attention (months of yr backwards)
Fluctuating course

Score of 4 or more = delirium

8

State the 4 hallmark features of delirium, described by the confusion assessment method (CAM)
Give some ways of testing these

Acute onset and fluctuating course (collateral Hx)
Inattention (months of yr backwards)
Disorganised thinking (how did you get to hospital?)
Altered consciousness (alert, vigilant, lethargic, stupor, coma)

9

How is delirium mainly treated?

Support (oreintation, sleep, environment), advice, reassurance, education
Identify and treat causes
Symptom control
Follow up and review

10

Which medication may be used for delirium?

Haliperidol low-dose oral
Quetiapine if Parkinson's
Benzodiazepine if alcohol withdrawal

11

List precipitating factors for getting delirium

PINCH ME

PAIN
ILLNESS: urinary retention
INFECTION: UTI, lungs, stomach
NEUROLOGICAL: withdrawal, alcohol
CONSTIPATION
CATHETER
CARDIOEMBOLIC
HYDRATION
HYPO: thyroid, natraemia, kalaemaia, thermia, glycaemia, xia
MEDICATION: new meds/ change in meds
ENVIRONMENTAL: hospital, surgery

12

What must be considered when discussing treatment with a delirious patient?

Capacity

13

What medication must be stopped in delirium?

Nephrotic drugs (check for intrinsic renal disease)
Strong opiates
Sedatives

14

What must be assessed and optimised when managing a delirious patient?

Hydration
BP/ perfusion

15

Why must a delirious patient be followed up?

Address flashbacks/ recollection
Risk factor for dementia
Risk of further episodes of delirium

16

What phrases can be used to reassure family/ carers?

'Acute state of confusion'
'I understand they are not themselves, this must be upsetting'
'Usually due to underlying cause - infection'
'Distressing symptoms usually resolve in a week, sometimes longer'