Table 3:
Assessment of Patient with Delirium
  • Physical Status
    • History
    • Physical and neurologic examination
    • Review of vital signs and anesthesia record if postoperative
    • Review of general medical records
    • Careful review of medications and any correlation with behavioral changes
  • Mental Status
    • Interview
    • Cognitive tests (eg, clock drawing, digit span, Trailmaking)
  • Basic Laboratory Tests for All Patients with Delirium
    • Blood chemistries (electrolytes, glucose, calcium, albumin, urea nitrogen, creatinine, aspartate transaminase [SGOT], alanine transaminase [SGPT], bilirubin, alkaline phosphatase, magnesium, and phosphate)
    • Complete blood count
    • Electrocardiogram (ECG)
    • Chest x-ray
    • Measurement of arterial blood gases or oxygen saturation
    • Urinalysis
  • Additional Laboratory Tests As Indicated by Individual Clinical Conditions
    • Urine culture and sensitivity
    • Serum and Urine drug screen
    • Blood tests (eg, venereal disease reference laboratory [VDRL] test, heavy metal screen, vitamin B12 and folate levels, anti-nuclear antibody [ANA], urine porphyrins, ammonia, HIV
    • Blood cultures
    • Measurement of serum drug levels (eg, digoxin, lithium, theophylline, phenobarbital, cyclosporine)
    • Lumbar puncture (LP)
    • Computed tomography or magnetic resonance imaging of the brain
    • Electroencephalogram (EEG)
Adapted from the American Psychiatric Association's Practice Guideline for the Treatment of Patients with Delirium6

Copyright 2002 The Cleveland Clinic Foundation

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