In delirium management, which approach is emphasized as the first action?

• A. Increase antipsychotics
• B. Identify and treat reversible causes and minimize deliriogenic meds.
• C. Initiate benzodiazepines immediately
• D. Isolate patient

Answer: (B)

The main idea is that delirium is usually driven by reversable factors, so the first action is to identify and treat those causes and minimize meds that can trigger delirium. Start with a thorough assessment for contributors such as infection, dehydration, electrolyte abnormalities, hypoxia, organ dysfunction, pain, urinary retention, constipation, sleep disruption, sensory impairment, and adverse drug effects. Review the patient’s medications and reduce or discontinue those known to worsen delirium—benzodiazepines, anticholinergics, sedatives, and inappropriate polypharmacy are common culprits. Correct reversible issues (ensure adequate fluids and oxygenation, manage pain and bowel function, address electrolyte imbalances, and optimize sleep and orientation). Implement nonpharmacologic supports like reorientation, a stable routine, familiar surroundings, and assistive devices (glasses, hearing aids). Pharmacologic treatment is reserved for situations where agitation or distress remains after addressing underlying factors. Isolating the patient is not helpful and can worsen confusion.