🧠Delirium
✅ Definition:
Delirium is a sudden, acute disturbance in mental abilities, characterized by confusion, disorientation, altered consciousness, and impaired attention — typically reversible and temporary.
✅ Causes:
-
Infections (e.g., UTI, pneumonia)
-
Fever, dehydration
-
Electrolyte imbalance
-
Drug or alcohol intoxication or withdrawal
-
Head injury
-
Post-surgery (especially in elderly)
-
Hypoxia
-
Organ failure (renal, hepatic)
✅ Signs and Symptoms:
-
Sudden confusion or disorientation
-
Restlessness or agitation
-
Hallucinations or delusions
-
Poor memory or attention
-
Sleep disturbances
-
Speech may be incoherent or rambling
-
Fluctuating alertness (better in day, worse at night)
✅ Diagnostic Evaluation:
-
Clinical observation + mental status exam
-
Blood tests (CBC, electrolytes, LFT, RFT)
-
Urine test (for infection, drug screen)
-
CT/MRI (if head trauma suspected)
✅ Management:
-
Treat underlying cause (e.g., infection, dehydration)
-
Ensure safety – prevent falls, injury
-
Reorient frequently – use clocks, calendars
-
Ensure hydration and nutrition
-
Use low-dose antipsychotics (if severely agitated)
✅ Nursing Management:
-
Maintain calm, well-lit environment
-
Reassure and reorient the patient
-
Monitor vitals, mental status
-
Avoid physical restraints unless necessary
-
Involve family for support
-
Promote sleep hygiene and hydration
✅ Pathophysiology (Flow Chart – Copy-Ready):
Trigger (infection, dehydration, drugs)
⬇
↓ Neurotransmitter balance (e.g., acetylcholine)
⬇
↓ Brain function (esp. attention, cognition)
⬇
Acute confusion → Delirium