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Digital Seminar

Altered Mental Status: Connecting the Dots of Delirium, Dementia and Psychosis


Faculty:
Joyce Campbell, MSN, CCRN, SCRN, FNP-BC
Duration:
6 Hours 12 Minutes
Copyright:
Oct 11, 2017
Product Code:
POS077450
Media Type:
Digital Seminar
Access:
Never expires.


Description

  • Diagnostic challenges: Potential for involvement of one or more body systems
  • Take away life-saving interventions to prevent or treat delirium
  • Head to toe and diagnostic workup to identify cause
  • Find out the latest EBP for treating dementia
  • Be alert for common diseases and drugs causing AMS
  • What about the mentally ill patient with delirium?

Attention Health Care Professionals!! You play a vital role in identifying and assisting with resolution of problems affecting patients with altered mental status. The patient that you treat for altered mental status may be the life you save.

Delirium… Dementia… Psychosis

When facing a patient with altered mental status, no doubt you have caught yourself saying, “What is going on?” It is time to STOP, LISTEN, LOOK and ACT. This seminar dissects altered mental status (AMS), to identify the problem and lead the way to problem resolution. The study of AMS is like taking a combination med-surg and neuropsychiatric course, as one must look at all body systems when evaluating potential causes of AMS.

Every day, patients present with altered mental status in a variety of settings….ED, ICU, med/surg, geriatric, psych units, rehab, long-term care. The list goes on! Connecting the dots and identifying the problem may be life saving for the patient. You will leave with new assessment tools and strategies to alter the course for your patient experiencing an altered mental status condition.

CPD


CPD
- PESI Australia, in collaboration with PESI in the USA, offers quality online continuing professional development events from the leaders in the field at a standard recognized by professional associations including psychology, social work, occupational therapy, alcohol and drug professionals, counselling and psychotherapy. On completion of the training, a Professional Development Certificate is issued after the individual has answered and submitted a quiz and course evaluation. This online program is worth 6.25 hours CPD for points calculation by your association.

Handouts

Faculty

Joyce Campbell, MSN, CCRN, SCRN, FNP-BC Related seminars and products


Joyce Campbell, MSN, CCRN, SCRN, FNP-BC, has been involved in the nursing field for 35 years. For over 25 years, she taught in an associate degree nursing program where her primary focus was the theory and clinical instruction of neuroscience nursing. In addition to teaching, she has been employed by Comprehensive Health System in Chattanooga, Tennessee for the past 30 years. At Erlanger, she has adopted many roles, including neurosurgical and trauma critical care staff nurse, educator and nurse practitioner. Currently, she serves on the neuroservice line committee and provides stroke education to staff and patients. Erlanger Southeast Regional Stroke Center, an accredited Primary Stroke Center, houses a leading-edge stroke care facility serving over 2000 stroke patients annually.

Through her work at Erlanger, Joyce is able to experience, first hand, the latest innovative strategies for extending the window of treatment for stroke patients. She holds a BSN from East Tennessee State University, an MSN from the University of Tennessee at Knoxville, and completed post-graduate studies at the University of Alabama at Birmingham. Joyce is an active member of the American Association of Critical Care Nurses, the American Association of Neuroscience Nurses, American Association of Nurse Practitioners, and the Chattanooga Association of Nurses in Advanced Practice, where she has served as president and is a member of the educational committee.

 

Speaker Disclosures:
Financial: Joyce Campbell has an employment relationship with Erlanger Southeast Regional Stroke Center. She receives a speaking honorarium from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Joyce Campbell is a member of the educational committee for the Chattanooga Association of Nurses in Advanced Practice.

 


Objectives

  1. Recognize the “red flags” indicating potentially fatal outcomes.
  2. Explain interventions to rapidly reverse the causes of AMS.
  3. Differentiate between delirium, dementia and psychosis.
  4. Identify the underlying causes of AMS.
  5. Select between new tools for assessment and evaluation.
  6. List the best diagnostic options to differentiate among possible causes.
  7. Develop a treatment plan for the most common causes of AMS.
  8. Analyze practice guidelines for prevention and management of pain, agitation and delirium.

Outline

Life-Threatening Causes of AMS: Prepare to Intervene

  • Airway problems leading to hypoxia and CNS symptoms
  • Gross assessment of disability: GCS or AVPU
  • Rapid head to toe assessment
  • Look for rapidly fixable causes
  • History and physical… Asking the right questions
  • Diagnostic work-up
  • Coma and altered level of consciousness: Brain stem and cerebral hemispheres
  • Predictive model for the risk of delirium in hospitalized older patients
  • Intensive care delirium scanning checklist
  • Confusion Assessment Method
  • AACN Practice Alert
  • Break down: Delirium, dementia and psychosis

Common Conditions Causing Delirium

  • Medications – Adverse effects and interactions
    • Central acting agents
    • Sedative hypnotics
    • Anticonvulsants
    • Analgesics
    • GI agents
    • Antinauseants
    • Antibiotics
    • Psychotropic meds
    • Cardiac meds
    • OTC meds
    • Steroids
  • Medications – withdrawal syndromes
  • UTI
  • Pneumonia
  • Electrolyte disorders
  • Endocrine crisis: Hyper/hypothyroid, adrenal, diabetic, Wilson’s disease
  • Korsakoff syndrome
  • Transient global amnesia
  • Pain agitation

10 Life-Threatening Conditions Causing Delirium

  • Hypoxia
  • Hypoglycemia
  • Encephalopathy: Hypertensive and Werniche’s
  • Drug overdose
  • Acute neuro: Meningitis, SAH and seizures
  • CNS trauma
  • Sepsis

Delirium: Don’t Forget These Possibilities:

  • The patient with delirium related to structural changes
  • Subdural hematoma
  • Brain tumor
  • Normal pressure hydrocephalus
  • Stroke
  • Infectious disease and SEPSIS: The ticking time bomb
  • Not to be missed: Meningitis, encephalitis

Psychosis: Into Madness

  • Major depressive disorder
  • PHQ-9 screening instrument
  • Post-partum depression
  • Bipolar
  • Schizophrenia
  • Schizoaffective
  • Delusions, illusions, hallucinations
  • Positive and negative clinical manifestations
  • Pharmacology and other treatments
  • Personality Disorders
  • Schizotypal Disorder
  • A case of global amnesia

Dementia: The Work-Up

  • History
  • Mini mental
  • Sweet 16 Cognitive assessment tool
  • Radiological diagnostic work-up
  • Delirium plus dementia
  • Alzheimer work-up
  • Lewy body
  • Chronic traumatic encephalopathy

Interventions for the Common Problems

  • Memory loss and confusion
  • Reduced concentration
  • Hallucinations
  • Agitation
  • Sleep disturbance
  • Inability to carry out ADLs

Expanding the Window of Care: Current Research

Target Audience

Case Managers, Nurses, Physician Assistants, Social Workers

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