1. What are the features of delirium according to the DSM-IV? Select all that apply.
2. Which conditions should be met before a patient with delirium can be safely discharged from hospital? Select all that apply.
3. An 81-year-old man is brought to the emergency department with a several month history of progressive short-term memory loss. His family notes that he has been falling over the past few weeks and has had difficulty with his balance. On physical examination, you note an alert, attentive, and cooperative patient. His Mini Mental Status Exam Score is in the impaired range. Further neurologic examination reveals the presence of ataxia and broad-based gait. Sensation and strength testing is unremarkable. You also note the patient is wearing a diaper, which the family says is because he has difficulty controlling his bladder. Which two are the most likely causes of this patient’s short term-memory impairment?
4. An 80 year old woman is sent to your ED with several days of fluctuating level of consciousness and aggressive behavior. She is legally blind, wears a hearing aid, has limited mobility with a walker, and smokes. She was prescribed Valacyclovir and Amitryptiline for neuropathic pain from shingles last week. What patient vulnerability factors does she have that place her at higher risk of developing delirium? Select all that apply.
5. The same patient from the previous question is quite combative and distraught, and is repeatedly attempting to get out of bed and walk home in her gown while you are starting your assessment for delirium. Which of the following should be considered as an initial method of managing Mrs. McKay’s behaviour in your ED? Select all that apply.