Delirium management is FOUNDATIONAL nonpharmacologic with treatment of reversible causes: deprescribe high-risk medications (anticholinergics like diphenhydramine and oxybutynin, sedatives like zolpidem, dopamine antagonists like reglan), treat infection (pneumonia here), remove unnecessary tethers (Foley contributes to delirium), reorient, mobilize, sleep hygiene. Antipsychotics are REJECTED as routine; reserved for severe agitation harming self/staff with non-pharm failure (and only short term, low dose) — and AVOIDED in pure hypoactive delirium. Restraints worsen delirium. MRI is for focal findings, not initial step in delirium with clear medical precipitant.
In-depth explanation
Hypoactive delirium has higher mortality and is missed often. Use validated tools (CAM, CAM-ICU, 4AT) for screening. Ages 65+ at hospital admission warrant routine screening.
Clinical scenario
Reglan, oxybutynin, zolpidem, diphenhydramine on home med list. Sleep poor. Foley in place.
For study reference only. Always follow current clinical guidelines and your institution’s protocols.