I am going to present a case of a 53-year-old male patient, Mr. M, who arrived at the emergency department for treatment with a panic attack and confusion concerns. Mr. M is a surgeon, and his staff members have reported that he has been having trouble carrying out certain chart documentation-related tasks following a surgical procedure in the past four months. Mr. M has a history of major depressive disorder, hypertension, hyperlipidemia, and type 2 diabetes (Ra et al., 2023). Given these symptoms and medical history, we have arrived at a differential diagnosis of Acute Stress Reaction, Delirium, Depression with Psychosis, and Cognitive Impairment due to a medical condition such as hypoglycemia or infection.
However, after careful evaluation of the patient’s symptoms and medical history, our most highly suspected diagnosis is delirium. Delirium is a sudden change in mental function that a medical condition, medication side effects, or substance abuse can cause (Wilson et al., 2020). The patient’s recent panic attack, confusion, and problems completing tasks that he previously was able to complete, as well as his history of hypertension, hyperlipidemia, and type 2 diabetes, increase the likelihood that Mr. M may be experiencing delirium.
Given this suspected diagnosis, our emergency treatment plan for Mr. M includes administering benzodiazepines to treat his panic attacks and anxiety and obtaining a complete medical evaluation, incorporating blood tests to eliminate other possible contributing factors of delirium, such as infection, hypoglycemia, or medication toxicity. Our pharmacologic treatments for Mr. M include prescribing antipsychotic medication to help manage his confusion and agitation and considering adjusting medications for his hypertension, hyperlipidemia, and diabetes, as these conditions can contribute to delirium.
In addition to pharmacologic treatments, we will also be implementing non-pharmacologic treatments for Mr. M. This includes encouraging him to participate in rehabilitation activities such as physical therapy and occupational therapy to help him regain his mental and physical abilities, as well as providing psychological support to Mr. M and his family through counseling or support groups (Wilson et al., 2020). Our short-term goals for Mr. M’s treatment include:
- stabilizing his mental state and managing his symptoms of confusion and agitation,
- identifying and addressing the underlying cause of his delirium and
- ensuring that he can complete his daily tasks with minimal assistance.
Our long-term goals for Mr. M include maintaining his mental stability, preventing further episodes of delirium, and improving his overall quality of life through physical and mental rehabilitation. Moreover, In terms of health promotion and patient education, we will be teaching Mr. M and his family about the importance of managing his underlying medical conditions, such as hypertension, hyperlipidemia, and diabetes, to prevent future episodes of delirium (Thom et al., 2019). We will also educate them about the signs and symptoms of delirium and the importance of seeking medical attention immediately.
In conclusion, delirium is a sudden change in mental function that various medical conditions and medications can cause. Mr. M’s recent panic attack, confusion, and problems completing tasks, along with his medical history, make delirium the most highly suspected diagnosis. Our treatment plan for Mr. M includes a combination of pharmacologic and non-pharmacologic treatments to stabilize his mental state, improve his quality of life, and prevent further episodes of delirium.
References
Ra K., Ramanathan S., Duleep A., & Chabrashvili T. (2023). Subtle cognitive decline in a patient with depression and anxiety. Current Psychiatry, 22(2), 41-48. Web.
Thom, R. P., Levy-Carrick, N. C., Bui, M., & Silbersweig, D. (2019). Delirium. American Journal of Psychiatry, 176(10), 785-793. Web.
Wilson, J. E., Mart, M. F., Cunningham, C., Shehabi, Y., Girard, T. D., MacLullich, A. M., & Ely, E. W. (2020). Delirium. Nature Reviews Disease Primers, 6(1), 90. Web.