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.
...s, physicians, and family members on the importance of prevention, detection, and treatment of ICU delirium. When successful, the ICU staff can promote a healthy environment to support physical and physiological well-being.
4. Both benzodiazepines and alcohol effectively suppress neuronal excitability in the CNS through the GABA receptor. Alcohol also has the ability to suppress the excitatory neurotransmitter glutamate at the NDMA receptor. This drug combination can have a synergistic effect at the GABA receptor, resulting in an increase sedation and significant respiratory depression to the point where abuser stops breathing and loses consciousness. There is also an increased risk of accidents (i.e vehicle) due to cognitive
The framework of this model is utilized throughout hospital settings to form a basis for all nursing decisions in respect to nursing diagnosis, care plans, discharge planning, and quality assurance (Reynolds & Cormack, 1991). This conceptual model focuses on the effects of internal and external environments that contribute to someone’s behavior. Pain (being the internal force) in patients with altered mental status usually manifests externally in non-verbal cues. Nursing as the external force can use tools that focus on the non-verbal cues given by the patients to accurately assess the pain and properly treat it.
Journal of Critical Care, 503.) The leading causes of most errors among stress and interruption are other factors such as: wrong dosage, dose omissi...
Prevention of ICU psychosis should occur as soon as the patient has been in the ICU for a few hours. Review visiting policies for the facilities, provide great periods of sleep, by reducing the disturbing and noise levels in the patient room, also try to minimize shift change in nursing staff caring for the patient, assess the patient alertness for the place, date and time on every shift(Welker, M. MSN, 2016). ICU psychosis can be increase by health care professional awareness of early clinical signs of delirium during patients assessment(Arend, E., Christensen, M. 2009). ICU psychosis is affecting the majority of the patient admitted to the ICU. Evidence base shows that the ICU environment is contributed to it’s development. Delirium is increased with morbidity and mortality as well as increased with length of stay in the intensive care unit(Arend, E., Christensen,
Most alcoholics proceed to a stage where their brains or their bodies have been so harmed by alcohol that the effects persist even when they are not drinking. This stage may be reached...
According to Wilson (2005), sleep deprivation can cause not only traffic accidents, but also medical conditions such as: obesity, type 2 diabetes, metabo...
Jane had not slept for 72 hours and had poor diet and was observed not to be drinking fluids. Jane has a diagnosis of Bipolar
The second causative factor is task factors (Ogrinc, G. & Huber, S., 2010). The hospital had a conscious sedation policy in which Mr. B should have been on continuous blood pressure, electrocardiogram (ECG) and pulse oximeter monitoring throughout the procedure and until he met discharge criteria. However, this policy was not followed in Mr. B’s case. All practitioners administrating conscious sedation must pass training modules. Nurse J had completed the training modules but the LPN was the nurse checking on Mr. B. The LPN did not notify Nurse J of low oxygen
ince thiamine is an important cofactor in the pyruvate dehydrogenase complex, a deficiency caused by excessive alcohol intake can have devastating effects on the nervous and cardiovascular systems. Neurological effects caused by thiamine deficiency are known as Dry beriberi, while cardiovascular effects are known as Wet beriberi (Morse 1992). Thiamine deficiency can result in acetylcholine deficiency, which leads to memory loss and lack of concentration. Thiamine is responsible for the maintenance of nerve cells and improper maintenance caused by a deficiency can lead to tremors. It is interesting to note that putting a patient on an anti-seizure medication can result in thiamine deficiency (1992).
Sleep is a reoccurring act that is part of our daily lives. It is one of the most important elements of human health. The natural state of sleep has been studied throughout the years of human evolution. It occurs when hormones are released throughout the body to make the individual begin to fall asleep. The importance of sleep is often overlooked amongst humans, leading to a disorder. There are problems that occur in the human body that are of higher importance and require more attention. Sleep disorders should be viewed as a priority to humans because it alters human health, presents as a precipitating factor for other health problems, and can be treated quickly.
is characterized by “deterioration in the level of consciousness, with lethargy, decrease in arousal and headache. The timing of the development of cerebral edema is variable, within most cases occurring 4 to 12 hours after starting treatment. Several case reports showed the presence of cerebral edema before the initiation of therapy. A method of clinical diagnosis based on bedside evaluation of a neurological state in DKA have been developed” (Pandey).
Fatigue as defined in the Medical Dictionary is a "physical and/or mental exhaustion that can be triggered by stress, medication, overwork, or mental and physical illness or disease. Fatigue and sleepiness are often used interchangeable, however they are distinct experiences. Sleepiness refers to a disposition to fall asleep, while fatigue describes an overwhelming feeling of exhaustion, tiredness associated with a weakened physical and/or cognitive ability. Sleepiness and fatigue often coexist in many professions. The nursing profession is no exception. We are aware of media coverage of past catastrophic accidents. Fatigue has been noted as a major causative factor in some aviation and nuclear power industries accidents. The National
To sum up, there are mechanisms by which alcohol and a drug therapy may interact, producing different pharmacodynamic and pharmacokinetic changes. Some medications can have their effects potentiated by alcohol while others may have inhibited effects. However, not all of these interactions have clinical significance and impact on a particular individual. The data in the literature is not complete but it is widely observed the importance of alcohol to potentiate the effects of antidepressants, antipsychotics and sedatives. The ethanol interaction with drug therapy increases the risk of intestinal bleeding in people using aspirin and/or non steroidal anti-inflammatory drugs. To avoid complications, which may be severe it is important to inform the doctor about alcohol consumption before take all medicaments.
Damage to the nervous system in alcoholics has been recognized for many years. Some of the possible neurological effects of alcoholism include: Development of diseases caused by vitamin B deficiencies. Impairment of overall mental functioning. Some of the ancient physicians recognized an impairment of overall mental functioning in those who drank excessively and recent brain cell studies suggest that an alcoholic literally kills off brain cells at a more rapid pace than normal. If one destroys brain cells rapidly enough and for a long enough period of time, eventually the "cell bank" of reserves will be depleted, and the subject will begin to show impaired mental functioning. This appears to be the sequence of events observed in the EEG tracings and clinical observations of alcoholics.