Delirium: The Daily PANCE Blueprint
A 78-year-old woman is hospitalized for pneumonia and develops delirium. Despite implementing nonpharmacologic interventions including frequent reorientation, maintaining consistent staff, ensuring adequate lighting, and having family present, she remains severely agitated. She has pulled out her IV twice, is trying to climb out of bed, and is at high risk for falls. Her vital signs are stable and laboratory studies show improving infection markers. She has no history of alcohol use or sedative medications. Which is the most appropriate next step in management?
A. Begin continuous benzodiazepine infusion
B. Administer haloperidol 0.5-1 mg as needed
C. Start scheduled quetiapine 200 mg twice daily
D. Apply physical restraints
E. Begin morphine infusion for sedation
Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Neurology ⇒ Neurocognitive disorders (PEARLS) ⇒ Delirium
Also covered in Internal Medicine, and Family Medicine PAEA EOR topic lists