Long-Term Care

Trainer’s tip: Recognizing delirium and the common causes

LTC Nursing Assistant Trainer, October 20, 2011

If a resident's behavior or mental status is different than usual, suspect delirium. It is easily recognized in alert residents who suddenly develop confusion. In residents with cognitive impairment, the confusion seems to be worse than usual. The first approach in these residents is to increase fluid intake to see if the confusion clears. In the early stages, delirium may be identified by staff members who are familiar with how the resident functions in a variety of situation. Always perform a complete nursing assessment to identify the cause and rule out potentially serious problems. The most common causes of delirium are infectious circulatory, respiratory, and metabolic disorders. Others include:

  • Unfamiliar environment
  • Sensory deficits, deprivation, or overload
  • Exposure to chemicals of toxic substances
  • Dehydration
  • Inadequate oxygenation
  • Emotional stress
  • Chemotherapy
  • Trauma
  • Fatigue

This is an excerpt from the HCPro book, The Long-Term Care Nursing Desk Reference, Second Edition, by Barbara Acello, MS, RN.

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