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8 Cards in this Set
- Front
- Back
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what is the old criteria to diagnose delirium?
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1. Acute in onset (hours to days) 2. Fluctuates throughout the day 3. Cognitive disturbance and inattention 4. Altered consciousness (hyper-alert, stupor, drowsy) |
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What are the causes of delirium?
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well... many |
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what are some of the risk factors for delirium?
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- old age - polypharmacy (steroids) - anemia - substance misuse - electrolyte disturbances - post-op |
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what is the general management for delirium?
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2. monitor vital signs, I/O chart 3. regular investigations to identify the cause 4. discontinue unnecessary medicine 5. rehydrate patient 6. identify sources of pain |
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what are some of the non-pharmacological treatments?
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1. no mechanical restraints 2. thrice daily re-orientation via reality orientation board 3. early mobilization 4. visual or hearing aid provision 5. rehydration 6. sleep enhancement via warm milk, music, tapes 7. bright light therapy from 6-10pm 8. minimize lines and tubes 9. encourage family members to come daily |
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what are the pharmacological treatments for delirium?
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- 0.5-5.0 mg of haloperidol daily - Adequate pain management *** avoid BZD and anticholinergic agents, these will make patient more confused |
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prognosis of delirious patients?
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- typically lasts 10-12 days, but may be up to 2 months - mortality rate is high, at 6-18% - 60% will have persistent cognitive deficits, so treat fast - 3x higher risk of dementia |
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describe chemical restraint |
Applyingchemical restraint: 1)Try oral medication first: Olanzapinezydis 10mg or Risperidone quicklet 1mg or lorazepam 0.5to 1mg stat. 2)If fails: IM lorazepam 2mg (if antipsychotic naïve) or IMHaloperidol5-10mg stat 3)If still fails, combine IM lorazepam 2mg and IM Haloperidol 10mg 30minutes to 60 minuteslater. |
