What is Delirium?

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Delirium is a sudden, fluctuating, and usually reversible disturbance of mental function (Fan, Guo, Li, & Zhu, 2012). Delirium has been identified in several hospital settings, however occurs more frequently in an Intensive Care setting. Risk factors are not limited to a certain age, race, or gender. There are several long and short term adverse effects associated with Delirium, and may even leave the patient in a decreased mental state after discharge. It is important to use the proper assessment tools to identify delirium in patients. More so, it is imperative that the medical and nursing staff be aware of all risk factors, signs and symptoms, and interventions to minimize and properly treat delirium in the ICU setting. Patients in the Intensive Care Unit are at a high risk to develop delirium. It is one of the most common conditions encountered by the staff in an Intensive Care Unit. Delirium can be hyperactive or hypo active according to the patients’ behavior. Disorientation, agitation, hallucinations, or delusions are characteristics that may be observed in the patient with hyperactive delirium. Apathy, quietly confused, withdrawal, lethargy, and even total lack of responsiveness are all symptoms of hypoactive delirium. Some or all of these symptoms may occur at any time. While the cause of delirium is usually multifactorial, there are several risk factors can be identified. The risk factors can be divided into 2 categories: predisposing factors (host factors) and precipitating factors (Alexander, 2000). Predisposing factors are those that occur before an ICU admission, leaving them difficult to alter or correct. Examples of predisposing risk factors include: older age, history of hypertension, smoking, or... ... middle of paper ... ...managing the environment for the benefit of the patient to help reduce risk factors. Supportive measures by the nurse such as attention to noise reduction and lighting should be implemented to all patient care settings. The nurse should be proficient in their assessment method. The bedside nurse is in a front-line position to manage and prevent delirium. Although delirium risk factors are well known and the condition may be preventable in many patients, this has not, for the most part, been translated into concrete action at the unit level. More research needs to be done on the pathophysiology of delirium to better understand the cause, effect and how to better treat it. It is important that delirium is detected, diagnosed, and treated early without delay to improve patient outcomes and reduce the complications and severity of any associated underlying illness.

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