hhk1: | Applied Sciences

hhk1.pdf READ BELOW- Presentation: Demographics, onset of symptoms, history of present illness, associated risk factors  Dementia and delirium are both conditions that present a challenge to a person’s functional capacity, however, they contrast in their pathophysiology, presentation, duration, and treatment methods. It is important to note that both conditions have the possibility of overlapping symptoms which can present a diDiculty in diagnosing. Delirium is acute and temporary that can be triggered by an underlying condition such as a urinary tract infection, medication eDects, or an electrolyte imbalance. Whereas dementia is an irreversible chronic progressive disorder that presents with degeneration of cognitive decline including memory, functional reasoning, and communication. Those with underlying dementia are at an increased risk of delirium. Additional risk factors include age, gender, and socioeconomic status. Looking at the history of present illness for both conditions, it is most important to gain understanding in the timeline for presenting symptoms. Delirium typically is an acute presentation of lack of attention and awareness over days to weeks, whereas dementia is a progressive overall cognitive decline over months to years (Jandu et al., 2025). Pathophysiology: Similarities and di9erences in pathophysiology Dementia and delirium are the most common causes for presenting altered mental status within emergency departments. However, their etiologies diDer greatly. Delirium is likely an eDect from precipitating factors such as medication, acute illness, infections, and exacerbation of chronic medical conditions (Jandu et al., 2025). Conversely, dementia is a neurodegenerative process that is characterized by the accumulation of misfolded proteins, cerebrovascular disease, and other neuropathology (Chin, 2023). Similarities as previously mentioned include a person with underlying dementia having a delirium episode due to possible multifactorial causes. Assessment: Physical assessment techniques, appropriate diagnostic testing Physical assessment including a full neurological exam from the patient alone can provide symptoms that may present in both disorders supporting in a nonspecific diagnosis as symptoms of both disorders can coexist. This accentuates the importance of gaining history from the patient’s family members or caretakers. Assessments for delirium include the Memorial Delirium Assessment Scale, and the Delirium Rating Scale (DRS/DRS-98) (Buttaro et al., 2020). For dementia evaluation, cognitive testing such as Mini Mental State Examination (MMSE), Mini-Cog, and the Katz Index of Independence in Activities of Daily Living can provide insight to aid in exclusion. Additionally, labs including a CBC, TSH, vitamin B12, folate, and a metabolic screening help to exclude other potential causes of cognitive issues. If the patient has a history of taking medications such as digoxin, carbamazepine, theophylline, Depakote, a measurable level should be ordered (Buttaro et al., 2020). Imaging necessary to aid in diagnosis include a non-contrast CT scan or an MRI. Diagnosis: Additional di9erential diagnoses to consider, positive findings for each diagnosis Alcoholic dementia, liver disease, hypothyroidism, hypoglycemia, adrenal insuDiciency, Cushing disease, vitamin deficiencies including thiamine, b12, and folic acid, traumatic injury, infectious disease such as viral encephalopathy, Alzheimer dementia, vascular dementia, neurosyphilis, Creutzfeldt-Jakob disease, and Parkinson’s disease are all potential diDerentials for both conditions. Management: Similarities and di9erences in pharmacologic and nonpharmacologic treatments, client education, referral, and follow-up care For both dementia and delirium, depending on the stage of development helps facilitates the treatment protocol. The goal of management is to treat all correctable factors that may inhibit cognition, promote activities that enhance cognition, address safety concerns, and look into potential pharmacological management. Dementia diagnoses require more interprofessional collaborative management since there is no cure of the disease process and is a degenerative disorder that worsens with age. Pharmacological treatment for dementia may include cholinesterase inhibitors, and NMDA (N-methyl-D-aspartate) receptor antagonists. Non-pharmacologic treatment include cognitive behavioral therapy (CBT). INSTRUCTIONS BELOW- 1. Read above and respond by Engaging by oDering new insights, applications, perspectives, information, or implications for practice based on the topic. a. Communicate using respectful, collegial language and terminology appropriate to advanced nursing practice. Professionalism in Communication: Communicate with minimal errors in English grammar, spelling, syntax, and punctuation.  b. Reference Citation: Use current APA format to format citations and references and is free of errors.  References must be within 5 years. 2 paragraphs and 2 reference needed