Term
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Definition
related to sense data – ex: hallucinations/ hearing voices
not delirum |
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Term
| delerium deffers from dementia by the |
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Definition
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Term
| 6 characteristics of delerium |
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Definition
Changes in cognition
Rapid onset ( unlike dementia)
Attentional difficulties
Distractability
Dysfunctional thinking
Speech affected
Irrelevant, rambling, pressured, tangential,(getting away from the point) incoherent |
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Term
| delerium changes in perception |
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Definition
Visual hallucinations
May feel as if in a dream- depersonalization ( they cannot identify themselves )
Incapable of accurately performing tests of attention |
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Term
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Definition
can’t name four objects five minutes after being named
unable to recall any of these without prompting |
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Term
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Definition
Speech may be incoherent, dysarthric
Tone can vary wildly from incoherent mumbling to yelling and shouting
Rate often fluctuates between slow and pressured |
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Term
| sleep/wake cycle in delirum |
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Definition
Sleep in day, wake at night
Somnolence and hypersomnia
Insomnia
Vivid dreams and nightmares |
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Term
| duration and onset of delrium |
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Definition
Duration usually brief, over short time, hours to days; rare past one month
Typically abrupt onset; when slow probably associated with systemic illness or metabolic issue
Course typically fluctuates over the course of the day from one extreme to the other
Behaviors are typically worse at night |
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Term
| 13 people at high risk for delerium |
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Definition
Elderly
Post cardiotomy
Burns
Drug withdrawal- ETHO
AIDS
Those with high illness burden
Common; children and elderly
If pre-existing brain damage
Addictions
In critical care- sensory monotony
Entry or recovery from coma
Post-operative
Multiple medications |
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Term
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Definition
Due to general medical condition
Infection, metabolic disorders
Fluid and electrolyte disorders
Hepatic/renal disease
Thiamine deficiency
Hypertensive encephalopathy
Substance induced delirium
Medication side effects
Ingestion of toxins
Almost all medications may produce this |
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Term
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Definition
Routine unless otherwise indicated
CT scan for head injury
UDS- urine drug screen
MRI- head injury
LP- lumbar puncture (cns related)
Others specific to offending agent or suspected agent |
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Term
| top 3 outcomes of care w delerium |
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Definition
1.No harm to self/others
2. No additional injury or insult
3. Can test reality- say you don’t hear what they hear (voices) |
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Term
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Definition
| Thoughts do not conform to reality- even w contrary evidinceMay be persecutory, grandiose, somatic (extra ears) , nihilistic ( everything is dieing |
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Term
| delusions vs delerium define |
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Definition
| Hard to find what causes it unlike delerium which is medically caused and cured once thing is gone |
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Term
| 4 delusions interventions |
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Definition
Indicate not sharing belief
Do not argue
Use reasonable doubt- “ I find that hard to believe”
Do not do things that evoke elaboration of belief
Laughing, talking behind hand, whispering |
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Term
| 3 big no's of delsional people |
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Definition
1. no touching
2.no competive activivtes
3.no arguing |
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Term
| 4 desired outcomes from delusions |
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Definition
Able to test reality
Questions own thoughts and beliefs
Delusions should diminish within a month given proper medications
Teach medications so that patient will adhere |
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