NORTH
This tool is commonly used to assess cognition at the bedside
4AT
These medications should be avoided or used cautiously due to increased mortality risk
Antipsychotics
This condition has a sudden onset of confusion
Delirium
Visual aids clocks & calendars help with this
Orientation
Delirium symptoms often do this throughout the day
Fluctuate, vary, change
What are 2 hospital related triggers of delirium in frail patients?
Infection
medications/ polypharmacy
environmental change
dehydration
surgery
pain
immobility
Mobility and physiotherapy help to reduce this condition
Frailty
What is the first line management of delirium?
No pharmacological interventions
List 2 adverse effects of psychotropic medications
falls
sedation
Immobility
Extra pyramidal effects/parkinsonism: tremor, rigidity, akinesia (inability to initiate movement), bradykinesia (slowness of movement)
QT prolongation
Orthostatic hypotension or postural instability
This simple question can help screen for delirium
Is your patient more confused than usual?
SQID: single question in delirium
Frail patients are at higher risk of hospital harm, what are 3 risks?
falls
delirium
functional decline
pressure injuries
prolonged LOS
Altered nutrition
Immobility
A key feature of delirium is impaired _________?
attention
3 features of dementia
Onset: gradual/ chronic
Duration: long term/ permanent
Course: stable & progressive
Reversibility: Irreversible
If a psychotropic drug is administered for management of delirium, this should be accompanied by documentation, list 4 requirements
Consent from MTDM (medical treatment decision maker)
Behaviour exhibited
Non- pharmacological strategies used and level of effectiveness
Medication dose/time
Outcome of psychotropic administered
3 features of delirium
Onset: sudden/ acute
Duration: short term/ temporary
Course: fluctuates throughout the day
Reversible: often reversible with treatment
List 5 nursing interventions if delirium is supected
Reorientation
optimise sensory input/ aids (glasses/ hearing aids)
Monitor hydration & nutrition
Screen for infection
Environment modification
Safety 1st
Pain assessment
Assess for constipation
Review medications
Mobility
Engagement in activity