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24 Cards in this Set
- Front
- Back
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What is delirium?
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An acute state of confusion
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How is delirium different from dementia?
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1. Dementia is a chronic, progressive disorder, whereas delirium is an acute state of confusion
2. Delirium also differs from dementia in that it is usually short-term and reversible within 3 weeks 3. Delirium is often seen among older adults in a hospital setting or in a setting with which they are unfamiliar |
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What are the categories of delirium?
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1. Hyperactivity
2. Hypoactivity |
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Which is the most common category of delirium?
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Hyperactivity
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What are the characteristics of a client with hyperactive delirium?
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1. Trying to climb out of bed
2. Pulling out invasive catheters (e.g., urinary catheters or intravenous cannulas) 3. May become quite agitated and combative |
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What are the characteristics of a client with hypoactive delirium?
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Quiet, apathetic, and withdrawn
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What factors can cause delirium?
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1. Medication (especially anticholinergic drugs)
2. Metabolic disturbances 3. Infections 4. Surgical operations 5. Circulatory, renal, and pulmonary disorders 6. Nutritional deficiencies 7. Major loss |
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What are clients with delirium at risk for?
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1. Functional decline
2. Falls 3. Incontinence |
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What is the Confusion Asessment Method (CAM)?
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Assessment tool to assess older clients for acute confusion
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What are the parameters of the Confusion Assessment Method (CAM)?
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1. Acute onset and fluctuating course (e.g. Is there evidence of an acute change in mental status from the client's baseline?)
2. Inattention (e.g. Does the client have difficulty focusing?) 3. Disorganized thinking (e.g. Is the client's thinking and conversation disorganized or incoherent?) 4. ALOC (e.g. Is the client lethargic, hyperalert, or difficult to arouse?) |
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How is delirium diagnosed using the Confusion Assessment Method (CAM)?
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Presence of acute onset AND inattention with disorganized thinking OR altered level of consciousness
(1, 2, & 3 OR 1, 2, & 4) |
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How should a client with delirium be managed?
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1. Use a calm voice to reorient the client
2. Divert the client's attention away from devices or tubes 3. Playing tapes of soothing music in the client's room may have a calming effect 4. Giving the client a doll or stuffed animal to "fidget" with may prevent the client from removing important medical instrumentation 5. If the client has a favorite item, such as an afghan blanket or a picture, the nurse asks the family or significant others to provide it for the same purpose |
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What are the assessment tools for assessing for delirium (acute confusion)?
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1. Confusion Assessment Method (CAM)
2. Delirium Rating Scale (DRS) 3. Delirium Symptom Inventory (DSI) 4. Mini-Mental State Examination (MMSE) 5. Neelon/Champagne (NEECHAM) Confusion Scale |
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What is the difference between dementia and delirium?
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Dementia is a chronic, progressive cognitive decline
Delirium is an acute confusional state |
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What is the difference in onset between dementia and delirium?
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Dementia is slow
Delirium is fast |
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What is the difference in duration between dementia and delirium?
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Dementia last months to years
Delirium lasts hours to less than 1 month |
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What causes dementia?
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Unknown, possibly familial, chemical
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What causes delirium?
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Multiple factors, such as surgery, infection, drugs
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What is the difference in reversibility between dementia and delirium?
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Dementia cannot be reversed
Delirium is usually reversible |
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What is the management for dementia?
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Treat the signs and symptoms
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What is the management for delirium?
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Remove or treat the cause
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What are the nursing interventions for dementia?
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1. Reorientation not effective in the late stages
2. Use validation therapy (acknowledge the client's feelings and do not argue) 3. Provide a safe environment 4. Observe for associated behaviors, such as delusions or hallucinations |
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What are the nursing interventions for delirium?
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1. Reorient the client to reality
2. Provide a safe environment |
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What is the most difficult challenge in caring for clients with delirium?
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Those who experience delirium and dementia at the same time
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