Lab 3 - Delirium

What are the three most common cognitive problems in older adults?

Delirium, Depression, and Dementia.

What is delirium?

A state of acute mental confusion with a sudden onset.

What does the PINCH ME acronym stand for?

Pain, Infection, Constipation, Hydration, Medication, and Environment

What are the main characteristics of PAD Syndrome?

Pain, agitation, and delirium.

What are the 3 types of delirium?

Hyperactive, hypoactive, and mixed.

What are the defining traits of hyperactive delirium?

Agitated, restless, and aggressive.

What are the defining traits of hypoactive delirium?

Quiet, apathetic, lethargic, unaware, and withdrawn

What are the key characteristics of Alzheimer's Disease?

Changes to the brain's structure, including amyloid plaques, neurofibrillary tangles, and gradual loss of connections between neurons.

What causes vascular dementia?

Hypoxia, ischemic-hypoxic or hemorrhagic damage due to cardiovascular disease.

What is dementia with Lewy bodies associated with?

Parkinsonism.

How do you diagnose Creutzfeldt-Jakob Disease?

Lumbar puncture.

What are mild cognitive impairments (MCIs)?

Changes that do not affect the patient's ADLs.

What are some predisposing factors for delirium?

Older than 75, cognitive status, neurological diseases, decreased functional status, sensory impairment, dehydration, drugs, and comorbidities.

What are some precipitating factors for delirium?

Drugs, surgery, intercurrent illness, neurological diseases, prolonged sleep deprivation, and environmental factors.

What is the Confusion Assessment Method (CAM)?

A tool used to diagnose delirium based on behavioral observation and mental status examination.

What are the 4 main components of CAM?

Acute onset and fluctuating course of mental status, inattention, disorganized thinking, and altered LOC.

What are the clinical manifestations of delirium?

Change in consciousness and cognition that develops in a short period of time, presenting as hyperactive, hypoactive, or mixed delirium.

What are key nursing interventions for managing delirium?

Pain management, infection prevention, hydration, and addressing environmental triggers.

What is the role of drug therapy in treating delirium?

Used for severely agitated patients; Haldol is often the starting medication, with monitoring for side effects.

What is the purpose of caregiver support in managing delirium?

To prevent caregiver burnout and provide education and support strategies.

What are some common types of dementia?

Alzheimer's Disease, Vascular Dementia, Dementia with Lewy Bodies, Frontotemporal Dementia, and Creutzfeldt-Jakob Disease.

What is the typical onset period for delirium symptoms?

Hours to days.

What is the importance of a good health history in diagnosing delirium?

It helps identify pre-existing conditions and changes in mental status.

What is the Mini-Mental State Examination used for?

Cognitive testing to assess mental status.

What is the significance of hydration in delirium management?

Dehydration is a precipitating factor for delirium.

What should be monitored when using medications like Risperdal and Seroquel for delirium?

Monitor for side effects, as these medications can potentially worsen symptoms.

What is the relationship between delirium and hospitalization?

Patients who experience delirium during hospitalization may have lasting effects after discharge.

What are some environmental triggers for delirium?

ICU setting, recent surgery, and anesthesia.

What is the potential outcome for patients with mild cognitive impairment?

Uncertain if it is a precursor to Alzheimer's Disease or a separate disease process.

What is the significance of family interviews in delirium assessment?

They provide additional context and information about the patient's cognitive status.

What are some medications that are inappropriate for older adults?

Meperidine, Oxycodone, Ketorolac, Cyclobenzaprine, Nifedipine, Digoxin, Fluoxetine, Amitriptyline, Diazepam, Promethazine, Diphenhydramine, and Chlorpropamide.