Problem statement: Post-operative delirium is an exceedingly prevalent in older adults in many countries including Thailand. Moreover, post-operative delirium is the significant problem which usually occurs in older adults having orthopedic surgery, especially hip surgery. Post-operative delirium is a complex factor which leading to poor clinical outcomes such as physical and cognitive functional decline or disability, and death. A number of studies try to develop the multifactorial interventions for preventing post-operative delirium after hip surgery. However, those studies suggested that the practical key to preventing post-operative delirium is screening those patients who are at risk of delirium. Recently, there are little in researches …show more content…
The exclusion criteria are older adults who were not planned for elective hip surgery, pathologic hip fracture, head injury or hip fracture due to the motor vehicle collision, mental disorder or severe aggressive, and serious comorbidities illness which required ICU. Before invite to the study, the older adults with hip fracture will be assessed by the Mini Mental Status Examination (MMSE), Pain scale, and Frailty index (FI) for purposive inclusion in the study. During the pre-operative, participants will be evaluated by Pain scale, the Confusion Assessment Method (CAM; Thai version), the DEAR (Delirium Elderly At Risk) in Thai version, and instrumental activities of daily living (IADL). Then, the participants will be followed by the researcher and research assistants (well- trained by the researcher) every day after hip surgery for 5 days. The clinical characteristic and the day of developing delirium will be documented by the researcher and will be compared with those who were not developed the delirium post-operative. Finally, the statistical test will analyze in the study is t-test and multiple
Polderman, K. H. (2007). Screening methods for delirium: don't get confused! Intensive Care Med , 3-5.
Hip fracture is one of the most common injuries that occur mainly among of older individuals. Evidently, it restricts the ability of the patients to move freely without the help of any other individual. Moreover, it also causes significant pain and disruption of life to frail patients, which is why it is imperative to handle them with extraordinary care. It is clearly evident that these patients need continuous attention and care from other individuals, which is why it is considered a very challenging area in the field of nursing.
The purpose of this paper is to present a discussion of the application and evaluation of Post-Operative pain management in elderly patients with dementia in a rehabilitation setting.
It is evident from the literature that, the adverse effects of dementia make changes in patients quality of life by changing their behavioural and functional abilities including expression of feelings or communicational skills. As a result, it becomes a challenge for the health care provider to assess or identify pain or symptoms of pain in dementia patients when they are unable to articulate their needs. Using a pain measurement tool helps the health care provider to meet this challenge, thus improve the pain management in persons with severe cognitive impairment. Throughout the research, in order to find out the suitable diagnostic tool for pain assessment in patients with advanced dementia, author reviewed studies on different pain assessment
An estimated 8% of Americans, 24.4 million people, have PTSD at any given time. That is equal to the total population of Texas, according to PTSD United. This mental condition affects people who have gone through a traumatic situation before, and are holding onto the memory. PTSD became widespread and documented around the time of World War I, and has been rising since. There has never been true a cure. Many people do not pay much attention to people suffering from post-traumatic stress disorder. However, with a few awareness programs, one person could make all the difference in a victim’s life.
Over the past fifteen years Americas finest warriors have been sent all over the world battling the war on terror. According to the President, the wars and battles are now over. Due to the Presidents lack of combat experience, he fails to realise that the battles still continue. These battles are not in Afghanistan, Iraq, or any other country, the battles are in the minds of those combat Veterans. These Veterans are and will continue to relive those battles in their minds for the rest of their lives. This battle is the battle for inner peace, sanity, and a good night’s sleep. Doctors have related this disorder to a release of a chemical cocktail in the brain and have coined this battle PTSD (Post Traumatic Stress Disorder). If PTSD is related to a release of chemical cocktail in the brain, then pre-war vulnerabilities, combat, , and post-war re-experiences are triggers that release that cocktail and cause Veterans to get PTSD.
Phantom pain refers to the phenomenal experience of pain in a body part that has been amputated or deafferented (Flor, Nikolajsen & Jensen, 2006). The characteristics of phantom pain have been described to occur in quick and sudden attacks of pain shooting up and down the amputated limb as well as cases of constant, excruciating pain whilst intensely perceiving the amputated limb to be cramped or postured abnormally (Katz, 1992). Approximately eighty percent of amputees report suffering from or at least experiencing some level of phantom pain post amputation; therefore it is a prominent issue (Flor, Nikolajsen & Jensen, 2006). Phantom pain is neuropathic pain that has no individual trigger but instead a plethora of psychobiological aspects of neuroplasticity that contribute to the cause of phantom pain (Grusser, Diers & Flor, 2003). The following will: outline the role of the peripheral and central factors associated with phantom pain and discuss the cortical reorganisation of the somatosensory cortex in relation to phantom pain.
In elderly population most of the research carried out so far emphasizes on the functional problems and diseases. When it comes to successful aging elderly (SEA), it has been recommended that health status should be used to distinguish between elderly subgroups populace and disease-free people possible describe successful aging elderly (SAE).
Do you know that seven to eight percent of Americans’ will experience some form of PTSD at some point in their lives? PTSD is an acronym for Post-Traumatic Stress Disorder. The cause of this anxiety disorder can be onset by a number of horrific traumas including events such as death, war, and even sexual assault. PTSD is a serious illness that requires help for those who suffer from this silent killer. Clearly, this illness is a long lasting consequence of war and other traumas.
Pulmonary contusions are another consequence from trauma to the chest, possibly not as severe as examples prior, but still dangerous. A pulmonary contusion is usually due to a blunt trauma to the thoracic cavity; the trauma causes blood to accumulate in the lung tissues and alveoli without lacerating the lung tissues. The lungs swell with the blood in the tissues, like a contusion anywhere else on the surface of the body, hence the term, “bruised lung.” With a pulmonary contusion, the patient will present, “...Tachypnea and tachycardia; while auscultating, rales and decreased breath sounds can be heard. Wheezing, coughing, and productive blood streaked sputum can be present; hypotension and reduced cardiac output accompany. Respiratory distress
There are many different causes of liver damage. These can be grouped into various categories depending on the timing of the insult and the types of cells most severely affected. As the nature of injury often dictates patient outcome, these patterns of injury have important clinical implications.
Binge drinking or heavy drinking is a modern description for drinking alcoholic beverages with the primary intention of becoming intoxicated by heavy consumption of alcohol over a short period of time. It is a kind of purposeful drinking style that is popular in several countries worldwide, and overlaps somewhat with social drinking since it is often done in groups. The degree of intoxication, however, varies between and within various cultures that engage in this practice. A binge on alcohol can occur over hours, last up to several days, or in the event of extended abuse, even weeks. Due to the long-term effects of alcohol misuse, binge drinking is considered to be a major public health issue. The more often a child or adolescent binge drinks and the younger they are the more likely they will develop an alcohol use disorder called alcoholism.
The role of the nurse in the preoperative area is to determine the patient’s psychological status to help with the use of coping during the surgery process. Determine physiologic factors directly or indirectly related to the surgical procedure that may cause operative risk factors. Establish baseline data for comparison in the intraoperative and postoperative period. Participate in the identification and documentation of the surgical site and or side of body on which the procedure is to be performed. Identify prescription drugs, over the counter, and herbal supplements that are taken by the patient that may interact and affect the surgical outcome. Document the results of all preoperative laboratory and diagnostic tests in the patient’s record
According to National Institute on Alcohol Abuse and Alcoholism, more than 1,800 college students die from alcohol-related causes every year, while about 800,000 are being assaulted by other students because of drinking. About one in every four college students who binge drink also admit that they have experienced academic problems. Binge drinking is drinking multiple drinks in just a few hours to get drunk. Despite the fact that college drinking has caused many issues, it has not been stopped, yet. In article, “Why Colleges Haven’t Stopped Binge Drinking,” McMurtrie (2014) explains that this issue has not been resolved yet because many people still see alcohol abuse as general issue instead of seeing it an individual behavior. Because colleges
Pharmacology is a vital component in the perioperative practice. Medication use is monitored closely during the perioperative period. Preoperatively, there are certain drugs that must be discontinued prior to a surgery as they increase surgical risk, including anticoagulants, tranquillisers, corticosteroids and diuretics (Laws, 2010b). In fact, these drugs can increase the risk of respiratory depression, infection, fluid and electrolyte imbalance and increased risk of bleeding (Hamlin, 2010). Open communication is important in obtaining a medication history, and in identifying the drugs taken prior to the surgery. If any of these medications has be...