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1.5 CE Test Hours

Original Research

Recognizing Delirium in Hospitalized Children

A Systematic Review of the Evidence on Risk Factors and Characteristics

Contrada, Emily

AJN The American Journal of Nursing: April 2018 - Volume 118 - Issue 4 - p 37,47
doi: 10.1097/01.NAJ.0000532070.32468.be
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Recognizing Delirium in Hospitalized Children: A Systematic Review of the Evidence on Risk Factors and Characteristics

GENERAL PURPOSE:

To provide the details of a systematic review done to examine the evidence regarding the risk factors for and characteristics of acute delirium in hospitalized children.

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LEARNING OBJECTIVES/OUTCOMES:

After completing this educational activity, you should be able to

  • outline the findings of the authors’ systematic review.
  • list characteristics of acute delirium in hospitalized children.
  • identify the practice implications of the findings.
  1. Common characteristics of delirium include
    1. slow onset.
    2. steady decline.
    3. altered perception.
  2. In a literature review by Daoud and colleagues, one study that used “clinical suspicion” as its index reported a prevalence of delirium among hospitalized children of
    1. 5%.
    2. 15%.
    3. 25%.
  3. In a retrospective study by Colville and colleagues conducted among children ages 7 to 17 years who had been hospitalized, what percentage recalled having hallucinatory experiences during their stay?
    1. more than 30%
    2. about 50%
    3. nearly 70%
  4. Colville and colleagues reported that almost all the children who had hallucinatory experiences reported them to be
    1. brief and transient.
    2. highly disturbing.
    3. quite interesting.
  5. In the same study, almost all the children who had hallucinatory experiences were in a
    1. regular pediatric unit.
    2. postanesthesia care unit.
    3. pediatric ICU (PICU).
  6. Research in traumatic brain injury indicates that the immature, developing brain has different responses from those of the adult brain to the release of which of the following substances?
    1. cytokines
    2. hormones
    3. growth factors
  7. A common manifestation of hypoactive delirium is
    1. agitation.
    2. inattention.
    3. hallucinations.
  8. Studies excluded from the authors’ systematic review were those
    1. targeting children from birth through 21 years.
    2. that were qualitative.
    3. with no control group.
  9. The review findings indicated that, compared with boys, the incidence of delirium in girls is
    1. lower.
    2. higher.
    3. about the same.
  10. In a study of PICU patients, Traube and colleagues found that children with developmental delay were diagnosed with delirium how much more often than those without such delay?
    1. about twice as often
    2. almost 3 times as often
    3. more than 4 times as often
  11. In another study of PICU patients, Smeets and colleagues found that 84% of those with delirium were receiving
    1. corticosteroid infusions.
    2. sedative hypnotics.
    3. mechanical ventilation.
  12. Risk factors considered in the authors’ review included
    1. noniatrogenic causes.
    2. those secondary to the child's acute illness.
    3. medications that can precipitate delirium.
  13. Reporting on children with neuroblastoma, Traube and colleagues listed which of the following as a specific characteristic of postoperative delirium?
    1. lack of eye contact
    2. memory loss
    3. lethargy
  14. In one study by Grover and colleagues of children diagnosed with delirium, which of the following manifestations was most common?
    1. agitation
    2. impaired attention
    3. impaired short-term memory
  15. In another study, Grover and colleagues compared children's and adults’ patterns of delirium. They reported that children had a higher frequency of
    1. lability of affect.
    2. pressured speech.
    3. poor judgment.
  16. A study by Leentjens and colleagues found that, compared to adults with delirium, children with delirium were less likely to have
    1. agitation.
    2. hallucinations.
    3. sleep–wake cycle disturbances.
  17. Children are at greater risk for developing acute delirium when they have a Pediatric Risk of Mortality II score at or above which percentile?
    1. 40th
    2. 50th
    3. 60th
  18. According to the authors’ systematic review, one of the 5 most common characteristics of pediatric delirium is
    1. aggression.
    2. disorientation.
    3. restlessness.
  19. In this review, some characteristics of pediatric delirium can be categorized as circadian rhythm disturbances. These include
    1. depression.
    2. gastrointestinal irritation.
    3. sleep–wake cycle disturbance.
  20. Limitations of this review included all but which of the following?
    1. It was observational in nature.
    2. It used descriptive statistics for data analysis.
    3. The included studies had low levels-of-evidence grades.
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