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Preventing and identifying hospital-acquired delirium

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doi: 10.1097/01.NURSE.0000651808.80250.89
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INSTRUCTIONS Preventing and identifying hospital-acquired delirium

TEST INSTRUCTIONS

  • Read the article. The test for this CE activity is to be taken online at www.nursingcenter.com/CE/nursing.
  • You'll need to create (it's free!) and log in to your personal CE Planner account before taking online tests. Your planner will keep track of all your Lippincott Professional Development online CE activities for you.
  • There's only one correct answer for each question. A passing score for this test is 13 correct answers. If you pass, you can print your certificate of earned contact hours and access the answer key. If you fail, you have the option of taking the test again at no additional cost.
  • For questions, contact Lippincott Professional Development: 1-800-787-8985.
  • Registration deadline is December 3, 2021.

PROVIDER ACCREDITATION

Lippincott Professional Development will award 1.0 contact hour for this continuing nursing education activity. Lippincott Professional Development is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 1.0 contact hour, and the District of Columbia, Georgia, and Florida CE Broker #50-1223.

Payment: The registration fee for this test is $12.95.

Preventing and identifying hospital-acquired delirium

GENERAL PURPOSE: To provide an overview of hospital-acquired delirium and how to distinguish it from dementia and depression. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing-education activity, you should be able to: 1. Explain risk factors for delirium. 2. Discuss how the clinical manifestations of delirium differ from dementia and depression. 3. Plan appropriate prevention strategies for patients at risk for delirium.

  1. A possible mechanism of delirium involves
    1. cytokine activity.
    2. cholinergic excess.
    3. dopamine deficiency.
  2. A common reason younger patients may develop delirium is
    1. infection.
    2. loneliness.
    3. body image issues.
  3. Which of the following is known to cause or prolong delirium?
    1. bronchodilators
    2. anticoagulants
    3. corticosteroids
  4. Delirium genetics include an association with
    1. PSEN2 gene mutation.
    2. apolipoprotein E epsilon 4 allele.
    3. NOTCH3 gene mutation.
  5. Common manifestations of delirium include
    1. aphasia.
    2. flat affect.
    3. limited attention span.
  6. Lab testing for patients with delirium should include serum
    1. creatinine.
    2. troponins.
    3. myoglobin.
  7. If the underlying etiology for delirium remains unclear after routine diagnostics, what may be helpful?
    1. electromyography
    2. evoked potentials studies
    3. lumbar puncture
  8. The most important aspect of patient-centered care for those at risk for delirium is
    1. reorientation.
    2. prevention.
    3. assessment.
  9. Regular monitoring for major risk factors can reduce the incidence of delirium by up to
    1. 33%.
    2. 50%.
    3. 66%.
  10. What is not one of the six major risk factors for delirium?
    1. sleep deprivation
    2. dehydration
    3. history of depression
  11. An intervention that can help prevent delirium is
    1. opening window shades or blinds during the day.
    2. applying restraints as needed to minimize agitation.
    3. keeping the patient's room well-lit at night.
  12. Using the THINK DR DRE mnemonic, the H is a reminder to evaluate patients with delirium for
    1. hypoxemia.
    2. heart failure.
    3. hyperthyroidism.
  13. The onset of delirium is
    1. insidious.
    2. gradual.
    3. acute.
  14. A reversible cause of dementia is
    1. Alzheimer disease.
    2. vitamin B12 deficiency.
    3. head trauma.
  15. One challenge for nurses in following newly adopted delirium protocols is
    1. finding time to adopt the necessary practices.
    2. getting staff buy-in to the importance of following the protocols.
    3. gaining the trust of patients who require the protocols.
  16. According to Moore, one hospital reduced its rate of patient delirium by
    1. using root-cause analysis.
    2. designating a nurse champion.
    3. using screening tools for differentiation from dementia.
  17. An appropriate treatment for patients with delirium is supplemental
    1. folate.
    2. niacin.
    3. thiamine.
  18. Episodes of major depression require the presence of at leastfive depressive symptoms, including depressed mood and
    1. loss of interest.
    2. impaired recent memory.
    3. delusions.
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