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Delirium is defined as an acute decline in cognitive functioning and should be considered a medical emergency as it is often the result of a noxious disruption to equilibrium.

Involving the patient’s family, primary bedside nurse, and clinical nurse leader in the creation of a nursing care plan can also be instrumental in the success of these nonpharmacological delirium prevention strategies. A high index of suspicion can allow clinicians to recognize delirium promptly and search for the underlying cause. Workup includes a thorough history, physical examination, and investigations to identify acute illness or destabilized chronic conditions. It is not uncommon for patients to have both forms at various times during the course of the same illness. It is particularly easy to miss a patient with hypoactive delirium as they do not call attention to themselves, perhaps explaining why the hypoactive form is associated with a poorer prognosis.[1] The diagnosis of delirium requires a patient interview, a physical examination, cognitive testing, and a review of the medical chart and any collateral information. Delirium and physical restraint in the hospitalized elderly.

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