A 79-year-old woman has a 4AT score of 5 on admission. She has a background of well-controlled Alzheimer's disease (MMSE 18 at baseline). Her bloods s...

Question

A 79-year-old woman has a 4AT score of 5 on admission. She has a background of well-controlled Alzheimer's disease (MMSE 18 at baseline). Her bloods show Na 128 mmol/L, K 4.2 mmol/L, Urea 12.4 mmol/L, Creatinine 132 µmol/L, CRP 85. She has a temperature of 38.4°C and is producing small volumes of concentrated urine. What is the MOST appropriate approach to managing her delirium?

Accepted Answer

Focus on identifying and treating the underlying cause - in this case likely infection with dehydration and hyponatraemia

Answer

Prescribe Haloperidol 1 mg TDS to sedate her

Answer

Arrange an urgent MRI brain to exclude stroke

Answer

Start Donepezil as it may help resolve the delirium

Answer

Discharge home with oral antibiotics as delirium is not a serious condition

uk-dgm MCQ (SBA): Delirium - Identify and Treat Underlying Cause