Case Study- Acute delirium

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Dementia

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For most patients who have dementia, it was likely caused by Alzheimer’s disease. However, there is a difference between the patient’s symptoms of dementia and those of delirium. The inception of delirium happens in a short period while in dementia, the symptoms begin slowly and gradually worsen. This patient is likely to have hyperactive delirium. This is because the patient is inattentive, he is getting progressive confusion, has a visual hallucination, and is restlessness at night. Since dementia leads to progressive loss of memory and critical thinking skills because of loss as well as dysfunction of the brain cells, the patient is likely to have symptoms that are similar to those of delirium. Also, dementia patients tend to remain alert in the early stages but this patient has symptoms of delirium because of inattentiveness. Besides, this patient has nighttime restlessness which is common for patients with dementia since their cognitive skills are usually fine during the day (Stockwell, 2019).

This patient also has hypertension, mildly enlarged prostate, and urine inconsistency therefore further tests should be done to determine if he has any kidney related disease or the Parkinson disease (Vaughan, 2011). His blood pressure should be below 130/80 mm Hg and if it exceeds that then the patient should be under medication. Since he has a history with hypertension then he needs close monitoring. He should also, therefore, go through regular therapy to identify if he has any cognition difficulty (Nelson, 2011).

Mr. White needs their caregivers to give him extra attention and as they identify what triggers him as finding ways to reverse them. Support is important since he is getting hallucinations and confusion and could also get restless and night. Support will ensure that he does not injure himself. He should also be under medication for hypertension and as well as behavioral therapy to limit the urinary inconsistency for instance monitoring his fluid intake and scheduling trips to the bathroom.

References

Nelson, J. M. (2011). Cognitive Impairment in the Older Adult. Gerontology Nursing Case Studies: 100 Narratives for Learning, 187.

Stockwell, G., Santoso, R., Layton, K., & Grealish, L. (2019). Partnering for Discharge.

Vaughan, C. P., Juncos, J. L., Burgio, K. L., Goode, P. S., Wolf, R. A., & Johnson, T. M. (2011). Behavioral therapy to treat urinary incontinence in Parkinson disease. Neurology76(19), 1631-1634.




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