Nursing Care for Delirium

Delirium is an acute condition characterized by an abrupt decline in mental function, including memory, orientation, judgment, and reasoning. It is reversible and can fluctuate from day-to-day, and can last for hours, days, or weeks.

Okay, now, delirium is usually related to an underlying condition, such as fluid and electrolyte imbalance, glucose dysregulation, malnutrition, or systemic infections. Certain medications, like benzodiazepines, opioids, and anticholinergics, can also contribute to delirium.

Other risk factors include advanced age, untreated pain, sleep deprivation, immobility, and sensory deprivation or sensory overload; as well as being hospitalized and being in intensive care. Dementia is another risk factor for delirium; and likewise, delirium can increase the risk of developing dementia. Now, although the exact cause of delirium is unclear, it likely involves an interaction between one or more risk factors and a vulnerable patient that ultimately results in alterations in neuronal function in the brain.

Clinical manifestations include disorientation, meaning the patient doesn’t know where they are or what day it is; difficulty concentrating; and altered speech, that might be rambling and difficult to understand. Their emotional state can range from being irritable and agitated to being withdrawn and depressed. Also, they may experience hallucinations, which means they see, hear, or even smell things that are not actually real but feel very real to them; as well as illusions, or misinterpretations of reality; and delusions, or beliefs that are objectively false.

Alright, now the diagnosis of delirium is typically based on the patient’s history as well as a physical and psychological assessment. In addition, certain tools, like the Confusion Assessment Method, or CAM, can be used to gather information. After the diagnosis is confirmed, laboratory tests, as well as imaging tests, like CT or MRI scans are performed to identify the underlying cause.

Moving on to treatment, delirium is a medical emergency that must be recognized and treated promptly. The good news is that delirium is often reversible when the underlying condition is resolved.

Okay, when caring for a patient with delirium, your primary responsibilities include prevention, early recognition, and working with the health care team to identify and treat the underlying cause.