Recognizing Delirium

A patient who suffers from delirium will go from being relatively sane to suddenly becoming agitated, disoriented, paranoid, and hallucinatory. The patient may also have wild mood swings and begin to exhibit bizarre speech. Although many may mistake this abrupt behavioral shift as mental illness, there is a significant difference between mental illness and delirium. Mental illnesses, such as schizophrenia and bipolar disorder, are strictly illnesses of the mind, whereas delirium indicates distress of both the mind and the body. By understanding and being able to recognize delirium, a licensed vocational nurse (LVN) can help save the life of a patient by prompting appropriate treatment of the illness soon after onset.

Delirium develops when the patient suffers from a disease that causes deprivation of nutrients to the brain, an overflow of toxins to the brain, or a negative reaction to medication. It is important to recognize delirium in patients because the mistreatment of the illness, such as prescribing additional drugs to decrease the agitation and confusion, may simply aggravate the symptoms. Because LVNs have arguably the most interaction with the patient, it is important for the LVN to note sudden differences in the patient's behavior and report these to the physician along with information about what happened around the onset of the change. Timely and thorough reporting may help the doctor to diagnose the delirium, as well as determine its cause.

Although delirium is not always fatal, misdiagnosis and delayed treatment may result in death because the cause of the delirium is not addressed in time. The eventual cause of death can be the liver or kidney failure, lack of oxygen to the brain, respiratory or cardiac insufficiency or sepsis that triggered the delirium in the first place. Because of the potentially fatal nature of delirium, it is especially important for LVNs to be wary when patients, especially the sick or elderly, exhibit a sudden change in behavior and to make sure that the physician considers delirium before prescribing medications to treat nonexistent mental illnesses. Therefore, it is very important to identify the correct condition or illness to start treatment.