¿Cuál es el delirio

El delirio es una grave perturbación en la capacidad cerebral que da lugar a confusión en el pensamiento gy reducción de la conciencia de su entorno local. La estrella del delirio es para jugadores rápidos, que ocurre dentro de una hora o unos pocos días.
El delirio a menudo se remontan a uno o más factores que contribuyen, tal como una enfermedad médica grave o crónica, las diferencias en el equilibrio metabólico ( tal como bajo contenido de sodio), infección, medicación, cirugía, or alcohol or drug withdrawal.
Because symptoms of delirium and demencia can be comparable, input from a family member or caregiver may be essential for a physician to make an accurate diagnosis.

Symptoms of Delirium
Signs and symptoms of Delirium usually begin over a few or a few days. They often fluctuate thought the day. There could be periods where no symptoms are shown. Symptoms tend to be worst during the night when it’s dark, and things look less familiar.
Main signs and symptoms include:

Reduce awareness of the environment
This may result in:

  • An inability to remain focused on a topic or to witch topics
  • Getting stuck on an idea rather than responding to questions or conversation
  • Being simply distracted by irrelevant things.
  • siendo retirado, con poca o ninguna actividad o poca respuesta al entorno.

Pobres cognitiva / personas con impedimentos (Pensando) Habilidades
Esto puede aparecer como:

  • Mala memoria, eventos particulares o recientes
  • DIroientation, por ejemplo, sin saber dónde se encuentra o lo que eres
  • Dificultad para hablar o recordar palabras
  • la comprensión del habla Troblue
  • Dificultad para leer o escribir
  • discurso de senderismo o sin sentido

Cambios de comportamiento
Esto puede incluir:

  • Al ver lo que no existe (alucinaciones)
  • Inquietud, agitación o comportamiento combativo
  • hábitos de sueño perturbado
  • Reveal or night -day sleep wake cycle
  • Calling out, moaning or making other sounds
  • Being quiet and withdrawnspecifically in older adults
  • Lethargy slowed movement

Emotional disturbance
Esto puede aparecer como:

  • Ansiedad, fear or paranoia
  • Depression
  • Irritability or anger
  • A sense of feeling elated (euphoria)
  • Apathy
  • Radpi and unpredictable mood shifts
  • cambios en la personalidad

Types or delirium
Researchers have identified three types of delirium:

  • Hyperactive delirium – Probably the most obvious form to recognize this may include restlessness ( movement, pacing) rapid mood changes, agitation or hallucinations.
  • Hypoactive delirium -This may include inactive or reduce motor activity sluggishness, abnormal drowsiness or seem to be in a daze.
  • Mixed delirium This comprises both hyperactive and hypoactive symptoms. The person may suddenly shift back and forth from hyperactive to hypoactive states.

Delirium and dementia

  • Dementia and delirium may be especially challenging to distinguish, and a person may have both. Fewuqily delirium occurs in those who have dementia,
  • Dementia is a progressive decline of memory and cognitive skills due to the gradual degradation and loss of brain cells. The most frequent cause of dementia is Alzheimer’s diseases.
  • Some difference between the symptom of delirium and dementia include:
    One set of delirium transpires within a short time, while dementia usually starts with comparatively minor symptoms that gradually worsen over time.
    Attention, The capability to stay focused or sustain attention is dramatically impaired with delirium. A person with the early stages of dementia will remain alert.
  • Fluctuation. The presence of delirium symptoms can fluctuate significantly and frequently through the day. Whi;e people with dementia have better and worse times of the day. Thier memory and thinking skills stay a fairly consistent level during a day.

Cuándo consultar a un médico.
If a relative, friend or someone you care shows any signs of symptoms of delirium, see a physician, Your input about the person’s symptoms, as well as his or typical thought and everyday abilities, will be essential for a proper diagnosis and for dining the underlying cause.
If you notice signs and symptoms of delirium in an individual in a hospital or nursing hospital, report your cares to the nursing staff or doctor rather than assuming that those problems have been observed. Older people recuperating in the hospital or living in a long-term care facility are particularly at risk of delirium.

Causes
Fever occurs when the standard sending and receiving of signals in the brain become impaired. This impairment probably caused by a mixture of factors that make the brain vulnerable and trigger a malfunction in brain activity.

Delirium can have a single cause or more than one cause, such as a medical condition and medical toxicity. Sometimes there are no circumstances identified

Possible causes include:

  • Alcohol or drug abuse or withdrawal
  • A medical condition
  • Certain medications or drug toxicity
  • Metabolic imbalance, Such as low sodium and low calcium
  • Severe, chronic or terminal illness
  • Fever and acute infection, particularmente en los niños.
  • Cirugía u otros procedimientos médicos que incorporan anestesia
  • La falta de sueño o estrés emocional severo
  • Pain

Varios medicamentos o combinaciones de medicamentos pueden desencadenar delirio, incluyendo algún tipo de:

  • medicamentos para la alergia (antihistamínicos)
  • medicamentos para la enfermedad de Parkinson
  • medicamentos para el asma
  • Medicamentos para tratar el espasmo y convulsiones
  • medicamentos para el sueño
  • Medicamentos para los trastornos del estado de ánimo, como la ansiedad, y la depresión
  • enfermedades Parkison

Risk Factors

Cualquier condición que termina en una estancia en el hospital, especialmente en cuidados intensivos o después de la cirugía, increase the risk of delirium, as does being a resident in a nursing residence.

An example of other conditions that increase the risk of delirium include:

  • Oder Age
  • Visual or hearing impairment
  • Having multiple medical problems
  • Brain disorders such as dementia, stroke or Pakrisions’ disease

Delirium may last only a few hours or as long as several weeks or months. If issues that produce delirium symptoms are addressed, the recovery is often shorter.

The degree of recovery depends to some extent on the health and mental status before the onset of delirium. For example, individuals with dementia experience a significant overall decline in thinking skills and memory. People in better health are more likely to recover.

People . with other serious, chronic or terminal ailments may not regain the levels of thinking skills or function that they had before the state of delirium. Delirium is serious people is more likely to lead to:

  • Poor recovery from surgery
  • Need for institutional care
  • Increase risk of death, specifically with hypoactive delirium
  • The general decline in health.

Test and diagnosis of Delirium:

A physician will diagnose delirium based on medical history, test s to assess mental status and the identification or possible contributing factors An examination may include:
Mental status assessment A physician starts by evaluating awareness, pensando, and attention. This may be accomplished informally through conversation, or with test or screening that assess the mental state, Confusión, percepción, and memory.
Physical and neurological exam. The physician conducts a physical exam, checking for signs of health problems or underlying disease. A neurological examchecking vision, equilibrar, coordinación, and reflexes -ca n help determine if a stroke and another neurological disease are causing delirium.
Another possible test- The doctor may order blood, urine, and another diagnostic test. The brain-imaging test may be used when a diagnosis can be made with other available information.

Treatments and Drugs from Delirium

The first objective of treatment for delirium is to address any underlying cause or triggers – por ejemplo, by stopping the use of a particular medication or treating an infection.
Treatment then focuses on creating the best environment for healing the body and calming the brain.

  • Supportive care
  • Supportive care aims to prevent complications by:
  • Protecting the airway
  • Treating pain
  • Addressing incontinence
  • Encouraging the involvement of family members of familiar people
  • Avoiding use of physical restraints and bladder tubes
  • Avoiding changes in surrounding and caregivers when possible
  • Providing fluids and nutrition
  • Assisting with movement

Los medicamentos
Talk with the physician about evading or minimizing the use of drugs that may cause delirium. Certain medications may be required to control pain that is causing delirium.

Other types of drugs may help calm a person who does not understand the environment in a way the leads to severe paranoia, hallucinations or fear, and confusion or serious agitation.

These drugs may be needed when certain behaviors do the following:

Do not respond to nondrug treatments:

  • Prevent the predominance of medical examination or treatment
  • Endangerethe person of threatens the safety and well being or other people
  • These medications are normally reduced in dose or discontinued when the delirium is resolved

Preventing Delirium
The most encouraging approach to stopping delirium is to focus on risk factors that might cause episodes. Hospital environments present special changes. Because of the invasive procedures, loud noise, frequent room changes, poor light and lack of natural light can worsen confusion.
Evendicne indicates that these strategies – promoting good sleep habits, helping the person remain well oriented and calm, and help prevent other medical problems can prevent or reduce the severity of delirium.