Comprehensive exams for Mental Health Q 153
Nurse Josefina is caring for a client who has been diagnosed with delirium. Which statement about delirium is true?
A. It's characterized by an acute onset and lasts about 1 month.
B. It's characterized by a slowly evolving onset and lasts about 1 week.
C. It's characterized by a slowly evolving onset and lasts about 1 month.
D. It's characterized by an acute onset and lasts hours to a number of days.
Correct Answer: D. It’s characterized by an acute onset and lasts hours to a number of days
Delirium has an acute onset and typically can last from several hours to several days. Delirium, also known as the acute confusional state, is a clinical syndrome that usually develops in the elderly. It is characterized by an alteration of consciousness and cognition with reduced ability to focus, sustain, or shift attention.
Option A: It develops over a short period and fluctuates during the day. The clinical presentation can vary, but usually, it flourishes with psychomotor behavioral disturbances such as hyperactivity or hypoactivity with increased sympathetic activity and impairment in sleep duration and architecture. It is caused by a medical condition, substance intoxication, or withdrawal in addition to the medication side effects, as well as; it is no better explained by another preexisting, involving, or established neurocognitive disorder.
Option B: Delirium can be a life-threatening emergency. Affected patients require an appropriate evaluation with history taking, physical, and neurologic examination and laboratory tests. Physical examination should evaluate head-to-toe and vital signs to determine any possible cause. Neurologic examination should focus on evaluating new focal findings that suggest an intracranial cause, for example, a stroke.
Option C: Only 12% to 35% of delirium cases are recognized. The first thing one has to do is determine the patient’s baseline mental status and the acuity of the symptom presentation, delirium presents over hours to days. This step requires a knowledgeable informant to obtain the history. Although, it is necessary for the diagnosis to know if the disturbance in mental status started alone or with other symptoms as dyspnea or dysuria or with medication changes.