SR.

TIME SPECIFIC CONTENT TEACHING AUDIO EVALUATION

NO. OBJECTIV LEARNING VISUAL
E ACTIVITY AIDS

1. 3 min Explain the What is

Introduction DEFINITION: – Delirium is an acute organic mental disorder characterized delirium ?
and L
definition of by impairment of consciousness , disorientation and disturbances in E
delirium C
perception and restlessness.
T
U
INCIDENCE : R
2. 3 min Explain the E
incidence Delirium has the highest incidence among organic mental disorder.
rate of C
About 10 to 25% of medical -surgical inpatients, and about 20 to 40
delirium U
% of geriatric patients meet the criteria for delirium during M
hospitalization. this percentage is higher in postoperative patients. D
I
3. 5 min S
ETIOLOGY :
C What are the
Enlist the - Vascular- hypertensive encephalopathy, cerebral arteriosclerosis, U etiological
etiological S factors of
factors of intracranial haemorrhage
S delirium ?
delirium I
- Infections – encephalitis, meningitis.
O
- Neoplastic- space occupying lesions.. N
SR.NO. TTIME SPECIFIC CONTENT T\L ACTIVITY A\V EVALUATION
OBJECTIVE AIDS

- Intoxication – chronic intoxication withdrawal effects of

sedative hypnotic drugs
L
- Traumatic – subdural and epidural hematoma, contusion,
E
laceration, postoperative, heatstroke. C
- Vitamin deficiency – for ex, thiamine. T
- Endocrine and metabolic- diabetic coma and shock, uraemia, U
myxoedema, hypothyroidism, hepatic failure. R
E
- Metals- heavy mentals( leads, manganese, mercury,) carbon
monoxide and toxins. C
- Anoxia – anaemia , pulmonary or cardiac failure U
4. 5 min Describe the M
clinical CLINICAL FEATURES: What are the
features of D clinical features
 Impairment of consciousness- clouding of consciousness
delirium I of delirium ?
ranging from drowsiness to stupor and coma. S
 Impairment of attention- difficulty in shifting, focusing and C
sustaining attention U
 Perceptual disturbances- illusions and hallucinations most often S
visual. S
I
 Disturbance of cognition- impairment of abstract thinking and
O
comprehension , impairment of immediate and recent memory, N
increased reaction time.
SR. TIME SPECIFIC CONTENT T\L A\V EVALUATION
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 Psychomotor disturbance- hypo or hyper-activity, aimless groping or

picking at the bed clothes (flocculation), enhanced startle reaction.
L
 Disturbance of the sleep wake cycle- insomnia or in severe case total E
sleep loss or reversal of sleep wake cycle, daytime drowsiness, C
nocturnal worsening of symptoms, disturbing dreams or nightmares, T
which may continue as hallucinations after awakening. U
 Emotional disturbances- depression, anxiety, fear, irritability, R
euphoria, apathy. E

5. 2 min Explain the C

COURSE AND PROGNOSIS : U
course and What is
prognosis of M prognosis of
The onset is usually abrupt, the duration of an episode is usually brief, delirium ?
delirium
lasting for about a week. D
I
6. 5 min Explain the S
treatment for TREATMENT : C
delirium U
S
- Identification of cause and its immediate correction, for example, 50 S What is the
mg of 50 % dextrose IV for hypoglycaemia, O2 for hypoxia, 100 mg I treatment for
of B1 IV for thiamine deficiency ,IV fluids for fluid and electrolyte O delirium ?
imbalance. N
SR. TIME SPECIFIC CONTENT T\L A\V AIDS EVALUATION
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- Symptomatic measures- Benzodiazepines (10 mg diazepam

or 2 mg lorazepam IV )or antipsychotics (5mg haloperidol
L
or 50 mg chlorpromazine IM) may be given.
E
7. 10 min Explain the C
nursing NURSING INTERVENTION : T
intervention U
of delirium 1. Providing safe environment- R What are the
E nursing
- Restrict environmental stimuli, keep unit calm and well-
intervention for
illuminated delirium ?
C
- There should always be somebody at the patients bedside
U
reassuring and supporting M
- As the patient is responding to a terrifying unrealistic world
of hallucination illusions and delusions, special precautions D
are needed to protect him from himself and to protect others. I
S
2. Alleviating patients fear and anxiety –
C
- Remove any object in the room that seems to be a source of U
misinterpreted perception. S
- As much as possible have the same person all the time by the S
patients bedside I
- Keep the room well lighted especially at night O
N
SR. TIME SPECIFIC CONTECT T\L A\V AIDS EVALUATION
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3. Meeting the physical needs of the patient L

- Appropriate care should be provide after physical E
C
assessment.
T
- Use appropriate nursing measures to reduce high U
fever , if present R
- Maintain intake and output chart E
- Mouth and skin should be taken care of
C
- Monitor vital sign
U
- Observe the patient for any extreme drowsiness and M
sleep as this may be an indication that the patient is
sleeping into a coma D
4. Facilitate orientation I
S
- Repeatedly explain to the patient where he is and
C
what date, day and time it is U
- Introduce people with the name even if the patient S
misidentifies the people S
- Have a calendar in the room and tell him what day it I
is O
N
- When the acute stage is over take the patient out and
introduce him to others