Term
| What is the definition of delirium? |
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Definition
| A transient, reversible cerebral dysfunction that has an acute or subacute onset and is manifest clinically by a wide range of fluctuating mental status abnormalities |
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Term
| What changes in mental status are observed during deirium? |
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Definition
Global impairment in: thinking, memory, perception
Decreased attention
Changes in level of consciousness
Agitation/decreased motor activity
Disturbances in sleep/wake cycles |
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Term
| What is the occurence rate of delirium? |
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Definition
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Term
| What types of patients are at especially high risks of delirium? |
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Definition
Old people
Cardiac procedures
Burn px
Px. with pre-existing brain disease
Px in drug withdrawal
Px with aids |
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Term
| Are people with a psychiatric diagnosis predisposed to delirium? |
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Definition
| NO - they're not at any higher risk |
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Term
| What type of disorientation is common in delirious patients? |
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Definition
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Term
| What kinds of altered perceptions happen to delirious patients? |
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Definition
Delusions
Visual hallucinations
Auditory and tactile illusions (tubes are snakes) |
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Term
| What are some of the neurologic abnormalities in delirium? |
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Definition
Dysgraphia
Dysnomic aphasia (can't name common things)
Constructional abnormalities (can't draw)
Motor abnormalities -FALL RISKS!
EEG findings |
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Term
| What is a way that you can differentiate between delirium and psychosis? |
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Definition
In delirium, the EEG is abnormal
In psychosis, it's not |
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Term
| What happens to the emotional state of people who are delirious? |
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Definition
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Term
| How can you differentiate between delirium and dementia? |
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Definition
Delirium: acute, fluctuates, lasts shorter, perceptual problems
Dementia: insidious onset, chronic length, no perceptual disturbances, impaired orientation |
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Term
| What are life-threatening causes of delirium? |
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Definition
WHHHHIMP!
W: Wernicke's encephalopathy/withdrawal
H: Hypertensive encephalopthy
H: Hypoglycemia
H: Hypoperfusion of the CNS
H: Hypoxemia
I: Intracranial bleeding
M: Meningitis/encephalitis
P: Poisons/medications |
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Term
| What are non life-threatening causes of delirium? |
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Definition
I WATCH DEATH
I: Infectious
W: Withdrawal
A: Acute metabolic problems
T: Trauma
C: CNS pathology
H: Hypoxia
D: Deficiencies
E: Endocrinopathies
A: Acute vascular
T: Toxins/drugs
H: Heavy metals` |
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Term
| What is a risk in people who have dementia already and then get delirious? |
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Definition
| Their dementia can take a turn for the worse |
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Term
| What should you do if you suspect a patient is delirious? |
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Definition
Use the Confusion Assessment Method
Do a focused physical exam
Keep track of the time course
Do labs
Take labs based on the clinical presentation |
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Term
| How do you manage someone who is delirious? |
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Definition
Treat the underlying cause
Restrain
Monitor them closely! |
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Term
| What medications are appropriate for delirious patients? |
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Definition
As few as possible!
If necessary, use haloperidol of BZDs |
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