Flashcards in Delirium/Alcohol Withdrawal Deck (9):
Delirium typically becomes most severe at what time of day?
Evening and at night
Patient most lucid on morning rounds
Two threatening and potentially reversible causes of delirium?
Hypoxia and hypoglycemia
50% of elderly patients have delirium after this surgery?
Hip surgery following hip fracture
Treatment for agitation with psychotic symptoms (hallucinations and delusions)?
Low-dose haloperidol or risperidone
Do not give this drug with Delirium?
Benzodiazepines – they worsen confusion
Alcohol withdrawal symptoms? (And times)
Tremulousness (within six hours) – shakes, anxiety, easy startling, anxiety, diaphoresis, palpitations
seizures (6 to 48 hours) – tonic-clonic seizures occurring in clusters of 2 to 6 episodes
Alcoholic hallucinosis (12 to 48 hours) – mostly visual. Can be maligning voices.
Delirium tremens (48 to 72 hours) – hallucinations, agitation, and sympathetic hyperactivity (dilated pupils, fever, tachycardia, hypertension, diaphoresis, hyperventilation)
Drug of choice for alcohol withdrawal?
Treatment plan for alcohol withdrawal?
1. Either diazepam or lorazepam to make patient heavily sedated but responses
2. Rapid downward titration as agitation decreases, usually over 48 to 72 hours
3. Hydration, replacement of electrolytes, thiamine, B12