Discussion:

This week’s content discussed common psychiatric disorders in the Adult and Older Adult client.  Often times a secondary diagnosis is masked due to their psychiatric disorder.  Review the following case study and answer the following questions.

Mr. White is a 72-year-old man, with a history of hypertension, COPD and moderate dementia, who presents with 4 days of increased confusion, nighttime restlessness, visual hallucinations, and urinary incontinence. His physical exam is unremarkable except for tachypnea, a mildly enlarged prostate, inattentiveness, and a worsening of his MMSE score from a baseline of 18 to 12 today.

Mr. White’s presentation is most consistent with an acute delirium (acute change in cognition, perceptual derangement, waxing and waning consciousness, and inattention).

1. What is the most likely diagnosis to frequently cause acute delirium in patients with dementia?
2. What additional testing should you consider if any?
3. What are treatment options to consider with this patient?

Submission Details:

• Post your response to the Discussion Area by the due date assigned. Respond to atleast two posts by the end of the week.

ADDITIONAL DETAILS 

Diagnosis to frequently cause acute delirium

Introduction

Acute delirium is a common condition that occurs when a person’s brain becomes unbalanced due to an event such as surgery or other medical treatment. The condition can last for several days or even weeks and requires medical attention. In this article we’ll explain how to diagnose acute delirium and how it affects your health.

Acute Leukemia

Acute leukemia is a cancer of the blood, which can be acute or chronic. Acute leukemia is more common in children than adults. In fact, about 70% of all children who develop leukemia are diagnosed with an acute form.

Acute leukemia can cause delirium if it’s not treated properly by your doctor. The symptoms include:

• confusion and disorientation (which makes it hard to remember where you are)

• irritability or anxiety (you may feel confused)

Major Surgery

Post-operative delirium is a common complication of surgery. It can occur after any type of major surgery, but risk factors include age and pre-existing medical conditions.

Delirium can last for days or weeks after your operation and is usually caused by the medications you receive in recovery. If you have post-operative delirium, it’s important to get treatment from an experienced doctor (preferably one who specializes in this type of care). You may need intensive care on site at the hospital if your condition gets serious enough to require hospitalization—but don’t worry: this isn’t normally necessary unless there are other issues present that make it necessary for an extended stay inpatient facility such as hospice services or rehab facilities where patients are cared for around the clock by staff members trained specifically how best fit those needs into their schedule(s).

Cardiac Arrest (AHA, 2001)

Cardiac arrest is a sudden stop in the heart’s pumping action. It happens when there is no electrical activity or blood flow to the brain, which causes it to be starved of oxygen. If you have cardiac arrest and no one can get you back, your brain will begin to die within minutes.

Cardiac arrest can be caused by many things, including high blood pressure, low blood sugar levels and some drugs (such as cocaine).

Ischemic Stroke

Ischemic stroke is caused by a clot that blocks blood flow to the brain. Symptoms include sudden weakness or numbness in the face, arm, or leg on one side of the body; difficulty speaking or understanding speech; and decreased vision.

If you have been diagnosed with an ischemic stroke (also known as a “thrombotic stroke”), you should seek medical attention immediately—this can help prevent further damage from occurring.

Hypoglycemia (Mayo Clinic, 2013)

• Hypoglycemia, or low blood sugar, is the most common cause of acute delirium.

• This can happen when you have a very low level of glucose in your bloodstream. The condition causes you to lose consciousness and experience confusion, seizures and coma (Mayo Clinic, 2013).

• Severe cases are life-threatening and require immediate medical treatment. If left untreated for too long, hypoglycemia can lead to death (Mayo Clinic).

Takeaway:

• Delirium is a condition that occurs when a person has a mental illness and is unable to distinguish between what’s real and what isn’t.

• It can be caused by stressful situations, like being in jail or going through an emergency surgery, but it’s more common in older adults than younger ones because they’re more likely to have chronic conditions such as heart disease and diabetes that increase their risk of delirium.

Conclusion

There are many conditions that can cause acute delirium, but the most common ones are those mentioned above. Taking steps to reduce your risk of developing acute delirium will help you get better faster, and may even prevent it altogether if you’re at risk for it.