Geriatrics
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Virtually any medical illness, intoxication, or medication can precipitate delirium, an acute confusional state common among older persons. Delirium is associated with a high risk of morbidity and mortality, thus management requires thorough assessment and swift but careful action. ⋯ Several screening tools are available to aid this effort. Vigilance can help reduce the high number of patients discharged with unresolved symptoms.
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Urinary tract infections (UTIs)--including cystitis, pyelonephritis, and catheter-associated infections--are among the most common nursing home-acquired infections. Asymptomatic bacteriuria can be identified in 20 to 50% of nursing home residents who do not have bladder catheters and in 100% of those who do. ⋯ Treatment of cystitis can usually be managed in the nursing home with oral antibiotics. Initial therapy with a parenteral agent is often recommended in nursing home-acquired pyelonephritis.