delirium patients experiencing delirium. delirium also known as an “acute state of confusion” it...
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Patients Experiencing DeliriumDelirium
Delirium
• Also known as an “acute state of confusion”• It is considered a serious acute medical problem• Indicates there may be a serious medical
problem• Patients describe delirium as:
– The twigh light zone– Fog bank– A state of constant terror
Delirium can be described as:
• Starting and stopping suddenly
• Lasting a few hours, a few days or a few weeks
• Patient’s alertness fluctuates
• Patient knows person but not time and place
• Their attention is distracted easily, can not stay on one subject for very long
• They have NO short term memory
• Their thinking is disorganized and they ramble
• They have delusions and visual hallucinations
4 Key Features
1. Difficulty concentrating
2. No short term memory, disorientated, seeing things
3. Sudden onset, can go from very active to very sleepy
4. Delirium is caused by a medical problem such as a new medication or alcohol withdrawal
3 Types of DeliriumHyperactive• Agitated state with increase
activity and increased verbal behaviors
Hypoactive• More comment in elderly.
Quietly confused with some anxiety. Tired and withdrawn
Mixed• Patients move from
hyperactive to hypoactive states
What Causes Delirium
Outside hospital• Illness
– Pneumonia, UTI’s
• Depression• New medications• Alcohol and drug
withdrawal• Post operative• Previous delirium
Inside hospital• Dehydration, malnutrition• Surgery• Infections• Not sleeping• Not mobilizing• Unfamiliar environment• Sensory overload• Isolation and no windows
What to Do
Communication:• Eye contact at eye level• Identify self• Call patient by preferred
name• Be calm and speak slowly• Validate fears and
concerns• Use short and simple
sentences• Re orientate frequently
Environment:• Minimize noise and staff
changes• Provide food and fluids• Ask family for familiar
objects• Music• Promote sleep• Use clocks and calendars
to re orientate• Limit visitors• Have family sit with
patient
What to Do
Physiological:• Look for signs of pain• Check for
constipation• Check for urinary
retention• Toileting routines• Mobilize lots
Safety:• Use bed and chair
alarms• Move patient closer to
nursing station• Remove sharp
objects• Have patient wear
clean glasses and working hearing aides
Other Interventions to Consider
• No restraints, they only increase agitation
• Read the paper or your magazine to the patient. Let them read as well
• Elder Friendly Program has a TV for DVD’s and Videos
QUESTIONS?
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