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Delirium

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Delirium

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Delirium

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Delirium is described as an alteration in cognition and awareness. Typically, delirium presents quickly and over a short period of time and is always secondary to some condition that resolves over time. The patient with delirium is easily distracted and requires frequent assistance in focusing attention. Delirium may cause the patient’s speech to be incoherent due to rambling, and may appear irrelevant and pressured. Typically, delirium causes the patient to be disoriented to place and time and can cause hallucinations and short-term memory loss. Some predisposing factors of delirium include: illness, hypoxia, head trauma, seizures, substance abuse, substance withdrawal, systemic infections, and electrolyte imbalances.
8 KEY FACTS
MECHANISM
Rapid Onset
Rapid-rabbit On-switch

A key distinguishing feature of delirium is that the onset is not gradual and may be sudden, within minutes to hours to days.

Reversible
Reversed-hat

Contrasted with dementia, delirium is reversible by treating the underlying cause of the condition, such as infection, hypoxia, drug intoxication, etc.

ASSESSMENT
Hallucinations
Halloween-hallucination

Being “delirious” is often a combination of any or all three - hallucinations, delusions, and illusions. They may see, hear, or perceive things differently, fabricate them entirely, or misinterpret reality.

Decline in Cognition
Down-arrow Cog-brain

Delirium often leads to a decline in cognition. This decline may cause the patient to be disoriented in person, place, or time, experience poor judgment, and have impairments in memory.

Short Attention Span
Shorts with Attention Span

A patient with delirium often has a short attention span. They may experience difficulty focusing and will require frequent reminding and refocusing on tasks they attempt to complete.

Rapid Speech
Rapid-rabbit Speech-bubble

The patient’s speech can become garbled or incoherent due to delirium but is often rapid. The patient may appear pressured when speaking, and their speech may be irrelevant to the situation.

Change in Activity Level
Delta Activity Level

Patients with delirium often have a change in activity level that may include problems with the normal sleep/wake cycle, as well as insomnia.

Mood Swings
Moody-masks on Swing

Patients may be fearful, anxious, suspicious, aggressive, or violent. Their mood tends to fluctuate frequently, and they are often stimulated easily by stressors.

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