Podcast
Questions and Answers
What is the primary approach when dealing with a client who is experiencing delirium?
What is the primary approach when dealing with a client who is experiencing delirium?
- Talk to them loudly to get their attention
- Stay with them and reorient them to their surroundings (correct)
- Isolate them from other patients
- Provide them with stimulating activities
What should be the tone of voice when communicating with a client in a state of delirium?
What should be the tone of voice when communicating with a client in a state of delirium?
- Monotonous and indifferent
- Calm and clear (correct)
- Loud and expressive
- Fast and hurried
What is a common medication used for clients experiencing substance withdrawal in delirium?
What is a common medication used for clients experiencing substance withdrawal in delirium?
- Antidepressants
- Benzodiazepines (correct)
- Stimulants
- Antipsychotics
Why might some physicians choose not to administer additional medications to a client with delirium?
Why might some physicians choose not to administer additional medications to a client with delirium?
What environment modification is recommended for clients who are delirious?
What environment modification is recommended for clients who are delirious?
What is a common emotional state observed in individuals experiencing delirium?
What is a common emotional state observed in individuals experiencing delirium?
Which of the following symptoms is least likely to be associated with delirium?
Which of the following symptoms is least likely to be associated with delirium?
What underlying factors can contribute to the risk of developing delirium?
What underlying factors can contribute to the risk of developing delirium?
What is the first step in the treatment of delirium?
What is the first step in the treatment of delirium?
Which of the following best describes delirium?
Which of the following best describes delirium?
What characteristic behavior may individuals with delirium exhibit?
What characteristic behavior may individuals with delirium exhibit?
What are common causes of delirium?
What are common causes of delirium?
At what age group is there an increased risk for developing delirium?
At what age group is there an increased risk for developing delirium?
How long can delirium typically last?
How long can delirium typically last?
During an episode of acute delirium, what must caregivers ensure?
During an episode of acute delirium, what must caregivers ensure?
Which of the following is not a symptom of delirium?
Which of the following is not a symptom of delirium?
What is a key feature that distinguishes delirium from other neurocognitive disorders?
What is a key feature that distinguishes delirium from other neurocognitive disorders?
Which of the following factors can predispose someone to delirium?
Which of the following factors can predispose someone to delirium?
Which symptom is commonly associated with delirium?
Which symptom is commonly associated with delirium?
In caring for clients with neurocognitive disorders, what should be prioritized?
In caring for clients with neurocognitive disorders, what should be prioritized?
What change occurred in the classification of neurocognitive disorders from DSM-IV to DSM-V?
What change occurred in the classification of neurocognitive disorders from DSM-IV to DSM-V?
What is characterized as an acute disturbance in cognition?
What is characterized as an acute disturbance in cognition?
Which of the following can cause delirium? (Select all that apply)
Which of the following can cause delirium? (Select all that apply)
Delirium is always irreversible.
Delirium is always irreversible.
What age group is considered at high risk for developing delirium?
What age group is considered at high risk for developing delirium?
Name two common symptoms of delirium.
Name two common symptoms of delirium.
The first step in treating delirium is to determine and correct the underlying _____ .
The first step in treating delirium is to determine and correct the underlying _____ .
What should be maintained in the room with clients who are delirious?
What should be maintained in the room with clients who are delirious?
What types of medications may be used for a client with delirium?
What types of medications may be used for a client with delirium?
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Study Notes
Neurocognitive Disorders Overview
- Neurocognitive disorders involve significant cognitive deficits affecting memory and functioning.
- Classification has shifted from DSM-IV, where conditions were grouped as delirium, dementia, and amnesic disorders, to DSM-5 categorizing them into delirium and mild/major neurocognitive disorders.
- Care focuses on promoting dignity, quality of life, and providing support to families and caregivers.
Delirium Characteristics
- Delirium is an acute cognitive disturbance marked by confusion, disorientation, and altered consciousness.
- Symptoms include short-term confusion, excitement, difficulty sustaining attention, disorganized thoughts, and fluctuating consciousness.
- Emotional instability often presents as fear, anger, or anxiety.
Causes and Predisposing Factors
- Common causes include infections (e.g., UTIs), high fever, head injury, low sodium levels, or effects of anesthesia, especially in the elderly.
- Age is a key risk factor, with individuals 65 years and older being particularly vulnerable.
- Substance intoxication or withdrawal can also lead to delirium.
Symptoms of Delirium
- Difficulty maintaining attention; distractibility and disorganized thinking are common.
- Speech may be rambling, irrelevant, or incoherent.
- Disorientation concerning time and place, recent memory impairment, and presence of delusions or hallucinations may occur.
- Levels of consciousness can range from hyper-vigilance to comatose states.
- Physical symptoms might include tachycardia, high blood pressure, flushed face, and dilated pupils.
- Patients can be either hyperactive or apathetic.
Treatment Approaches
- Identify and correct underlying causes (e.g., treat infections, manage electrolyte imbalances).
- Ensure patient safety by providing continuous supervision and reassurance during episodes of hallucination.
- Maintain a calm environment with minimal stimuli.
- Communication should be clear, calm, and supportive to foster a sense of safety and optimism.
Medication Considerations
- Medication usage is reserved for addressing specific symptoms or underlying conditions; caution is exercised to avoid exacerbating delirium.
- Low-dose antipsychotics may be used for agitation and aggression.
- Benzodiazepines are common for treating substance withdrawal-related delirium.
- Haloperidol is often preferred due to its shorter half-life.
Neurocognitive Disorders Overview
- Neurocognitive disorders involve significant cognitive deficits affecting memory and functioning.
- Classification has shifted from DSM-IV, where conditions were grouped as delirium, dementia, and amnesic disorders, to DSM-5 categorizing them into delirium and mild/major neurocognitive disorders.
- Care focuses on promoting dignity, quality of life, and providing support to families and caregivers.
Delirium Characteristics
- Delirium is an acute cognitive disturbance marked by confusion, disorientation, and altered consciousness.
- Symptoms include short-term confusion, excitement, difficulty sustaining attention, disorganized thoughts, and fluctuating consciousness.
- Emotional instability often presents as fear, anger, or anxiety.
Causes and Predisposing Factors
- Common causes include infections (e.g., UTIs), high fever, head injury, low sodium levels, or effects of anesthesia, especially in the elderly.
- Age is a key risk factor, with individuals 65 years and older being particularly vulnerable.
- Substance intoxication or withdrawal can also lead to delirium.
Symptoms of Delirium
- Difficulty maintaining attention; distractibility and disorganized thinking are common.
- Speech may be rambling, irrelevant, or incoherent.
- Disorientation concerning time and place, recent memory impairment, and presence of delusions or hallucinations may occur.
- Levels of consciousness can range from hyper-vigilance to comatose states.
- Physical symptoms might include tachycardia, high blood pressure, flushed face, and dilated pupils.
- Patients can be either hyperactive or apathetic.
Treatment Approaches
- Identify and correct underlying causes (e.g., treat infections, manage electrolyte imbalances).
- Ensure patient safety by providing continuous supervision and reassurance during episodes of hallucination.
- Maintain a calm environment with minimal stimuli.
- Communication should be clear, calm, and supportive to foster a sense of safety and optimism.
Medication Considerations
- Medication usage is reserved for addressing specific symptoms or underlying conditions; caution is exercised to avoid exacerbating delirium.
- Low-dose antipsychotics may be used for agitation and aggression.
- Benzodiazepines are common for treating substance withdrawal-related delirium.
- Haloperidol is often preferred due to its shorter half-life.
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