Question 1

How many subtypes of delirium are there?&#10;A) 2&#10;B) 3&#10;C) 4&#10;D) 5

Accepted Answer

There are 3 subtypes of delirium: hyperactive, hypoactive, and mixed.

Question 2

Delirium can result in ______&#10;A) Longer stay in critical care&#10;B) Post-traumatic stress disorder&#10;C) Higher mortality&#10;D) All of these

Accepted Answer

Delirium can lead to longer stays in critical care, increase the risk of post-traumatic stress disorder, and is associated with higher mortality rates.

Question 3

Which of the following is the main cause of delirium?&#10;A) Sensory overload&#10;B) The endotracheal tube&#10;C) The intravenous lines&#10;D) The continual presence of the nurse

Accepted Answer

Sensory overload is a common cause of delirium, especially in hospital settings, where patients can be overwhelmed by noise, activity, and the unfamiliar environment, leading to confusion and disorientation.

Question 4

What tool would you use to assess for delirium?&#10;A) MUST&#10;B) APACHE&#10;C) CAM-ICU&#10;D) NEWS

Accepted Answer

The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) is specifically designed to assess for delirium among ICU patients, making it the correct tool for this purpose.

Question 5

What does the acronym PADIS stand for?&#10;A) Pain, activity, distress, immobility&#10;B) Progress, activity, delirium, inactivity&#10;C) Pattern, assessment, distress, inactivity&#10;D) Pain, agitation/sedation, delirium, Immobility

Accepted Answer

PADIS stands for Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption, focusing on the management and assessment of these critical aspects in patient care, especially in intensive care units.

Question 6

Lieut has been ventilated for a week in intensive care. He is now waking up from the sedation but remains ventilated via a tracheostomy. During the night shift, he becomes distressed agitated and is pulling at his airway and intravenous lines and trying to get out of bed.
-What would be the most appropriate management of this situation?

A) Give him some night sedation so that he sleeps
B) Apply physical restraints so he doesn't pull out his airway and lines
C) Sit with him, provide reassurance and orientation
D) None of these

Accepted Answer

Sitting with the patient, providing reassurance and orientation, helps address the patient's distress and agitation by offering comfort and a sense of safety, which is crucial for patients waking up from sedation and adapting to being ventilated. This approach is patient-centered and aims to reduce anxiety without the immediate use of sedatives or restraints.

Question 7

Lieut has been ventilated for a week in intensive care. He is now waking up from the sedation but remains ventilated via a tracheostomy. During the night shift, he becomes distressed agitated and is pulling at his airway and intravenous lines and trying to get out of bed.
-What might have caused his distress and agitation?

A) Noise pollution
B) Light pollution
C) Sleep deprivation
D) All of these

Accepted Answer

All of these factors - noise pollution, light pollution, and sleep deprivation - can contribute to a patient's distress and agitation, especially in an intensive care unit setting where the environment can be quite disruptive to normal sleep patterns and sensory experiences.

Question 8

Freda insists on bringing her 8-year-old daughter to visit her grandmother who is ventilated but awake but confused about your critical care unit.
-How would you manage this situation?

A) Why is Freda insisting on bringing the daughter?
B) Check the unit policy on children visiting.
C) Is the environment safe for her to visit?
D) All of these

Accepted Answer

Each of these options is a valid consideration in managing the situation. Understanding Freda's insistence (A) can provide insight into the emotional or familial importance of the visit. Checking the unit policy on children visiting (B) ensures that the decision aligns with hospital guidelines. Assessing the safety of the environment (C) is crucial to ensure both the child's and the patient's well-being during the visit.

Question 9

Freda insists on bringing her 8-year-old daughter to visit her grandmother who is ventilated but awake but confused about your critical care unit.
-If the child visits her grandmother what support measures would you consider?

A) Sedate the grandmother so she's not confused.
B) Provide pre-visit information targeted at children.
C) Insist the child visits alone so as not to crowd the bed area
D) Insists the child brings her best friend.

Accepted Answer

Providing pre-visit information targeted at children can help prepare the child for what they might see, hear, and experience in the critical care unit, making the visit less frightening and more understandable. Sedating the grandmother could be medically inappropriate and doesn't address the child's needs. Insisting the child visits alone or with a friend doesn't provide the necessary emotional support or preparation for such a visit.

Deck 13: The Psychological Care of the Critically Ill