Self Directed Learning Package - University of Queensland

99 • Self Directed Learning Package - Advanced Registered & Enrolled NurseConsider possible causes of deliriumDelirium is often caused by a combination of factors including:• medicationse.g. opioids (especially with renal impairment), tricyclicantidepressants, benzodiazepines, corticosteroids any drugwith anticholinergic activity• drug withdrawale.g. opioids, alcohol, nicotine, benzodiazepines• metabolice.g. dehydration (diuretics use, hot weather, hypoglycaemia,hypercalcaemia)• urinary retention or constipation• infections (especially with indwelling urinary catheter)• kidney or liver failure• sensory impairmentsActivityIdentify THREE non-pharmacological managementstrategies (see over for suggestions) that you would liketo implement or further develop in your facility.Think about how you might do this in easily achievable,concrete steps.For example, ‘pin up reminder notices in each unit’ ismore specific and concrete than ‘keep staff quiet atnight’.• uncontrolled pain. 18,19ManagementKey PointWhen a resident is approaching the terminalphase, it is not always appropriate to actively treatthe cause of delirium, even if the cause is known.Decisions need to be informed by the residentsprognosis and any advance directives about activetreatment.