In delirium management, which step is essential to identify reversible etiologies?

• A. Delay evaluation until delirium worsens
• B. Rely only on clinical observation
• C. Review medications and obtain labs including electrolytes, glucose, and liver/renal function
• D. Initiate antipsychotic treatment immediately

Answer: (C)

In delirium, the priority is to uncover and treat reversible causes by checking what medications the patient is taking and by obtaining targeted laboratory tests. Many delirium-provoking factors come from drugs with anticholinergic or sedative effects, plus metabolic or organ problems that labs can reveal. By reviewing meds and checking electrolytes, glucose, and liver and kidney function, you can identify issues such as electrolyte disturbances, hypo- or hyperglycemia, or impaired drug clearance that are often reversible with prompt treatment or adjustment. This approach directly targets underlying causes rather than just masking symptoms, and it helps guide appropriate management rather than reflexively prescribing antipsychotics. Relying only on observation or delaying evaluation risks missing treatable problems, and starting antipsychotics without addressing the root cause may expose the patient to unnecessary risks.