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. Author manuscript; available in PMC: 2008 Feb 19.
Published in final edited form as: J Gerontol Nurs. 2007 Feb;33(2):40–49. doi: 10.3928/00989134-20070201-09

TABLE 2.

RN RESPONSES TO OPEN-ENDED QUESTIONS RELATED TO CAUSES AND MANAGEMENT OF DELIRIUM

Vignette Action to Take Suspected Cause
Dementia
  • Reorientation.

  • Monitor patient frequently to ensure safety, reorient patient as needed.

  • Notify physician, reorient patient often.

  1. Early Alzheimer’s.

  2. Being in a strange environment.

  3. Possibly medications.

    • Dementia.

    • Aging.

    • Possibly infection, early Alzheimer’s disease.

Hypoactive Delirium
  • Inform the physician.

  • Call the physician.

  • Notify the physician.

  • Overmedication, dehydration, constipation.

  • Delirium.

  • Could be sundowners syndrome or medication related.

Hyperactive Delirium
  • Call family to stay with patient instead of restraining.

  • Call physician.

  • Possibly restrain if in danger of hurting self. Take vital signs and check pulse oximeter.

  • Possible mental disorder, or sleep deprivation. Could be alcohol withdrawal.

  • Infection.

  • Sundowners.

Hyperactive DSD
  • Call physician, try to calm patient, restrain prn [as needed].

  • Reorient her, phone family and physician.

  • Safety measures, observation.”

  • Change in health, sleep disturbance.

  • Change in surroundings.

  • Worsening Alzheimer’s disease or dementia.

Hypoactive DSD
  • Check patient’s blood sugar or electrolytes.

  • Call physician, check vital signs.

  • Reorient, notify physician, patient safety, hydration/ nutrition/hygiene.

  • Aging, could be infection.

  • Gradual changes which occur with Alzheimer’s type patients.

  • Depression, too many medications.