せん妄とは何ですか

せん妄は混乱思考gとローカル環境の削減意識につながる脳の能力に重大な障害であります. せん妄の星は、通常、急速です, 時間または数日以内に起こります.
せん妄は、多くの場合、1つまたは複数の要因にさかのぼることができます, このような過酷なまたは慢性の内科的疾患として, あなたの代謝のバランスの違い ( 以下のような低ナトリウム), 感染, 薬物療法, 手術, アルコールや薬物離脱か.
せん妄の症状やので、 痴呆 匹敵することができます, 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:

  • トピックや魔女のトピックに焦点を当てたままにすることができません
  • アイデアに貼り付けではなく、質問や会話に対応しましょう
  • Being simply distracted by irrelevant things.
  • Being withdrawn, with little or no activity or little reply to the environment.

Poor/Impaired Cognitive (Thinking) Skills
This may appear as:

  • Poor memory, particular or recent events
  • DIroientation, 例えば, not knowing where you are or who you are
  • Difficulty speaking or recalling words
  • Troblue understanding speech
  • Difficulty reading or writing
  • Rambling or nonsensical speech

Behavior Changes
This may include:

  • Seeing thing that does not exist (幻覚)
  • Restlessness, agitation or combative behavior
  • Disturbed sleep habits
  • 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
This may appear as:

  • 不安, fear or paranoia
  • うつ病
  • Irritability or anger
  • A sense of feeling elated (euphoria)
  • Apathy
  • Radpi and unpredictable mood shifts
  • 人格変化

Types or delirium
Researchers have identified three types of delirium:

  • Hyperactive deliriumProbably 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. 認知症の初期段階を持つ人は、アラートのままになります.
  • 変動. せん妄の症状の存在は、一日を通じて大幅かつ頻繁に変動することができます. WHI;認知症の電子の人々は、その日のよりよいとより悪い時間を持っています. Thierメモリと思考スキルは、日中はかなり一貫性のレベルをとどまります.

医師の診察をするとき.
相対の場合, あなたが気に友人や誰かがせん妄の症状の兆候を示しています, 医師を参照してください, その人の症状についてのご入力, 同様に、彼または典型的な思考と日常の能力など, 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.

原因
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, particularly in children.
  • Surgery or other medical procedures that incorporate anesthesia
  • Sleep deprivation or severe emotional distress
  • 痛み

Several medications or combinations of drugs can trigger delirium, including some type of:

  • Allergy medications (antihistamines)
  • Parkinson’s disease drugs
  • Asthma medications
  • Drugs for treating spasm and convulsions
  • Sleep medications
  • Medications for mood disorders, such anxiety, そして、うつ病
  • Parkison diseases

危険因子

Any condition that ends in a hospital stay, especially in intensive care or after surgery, 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’ 疾患

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. 例えば, 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, 考え, and attention. This may be accomplished informally through conversation, or with test or screening that assess the mental state, 混乱, 知覚, and memory.
Physical and neurological exam. The physician conducts a physical exam, 健康上の問題や基礎疾患の兆候をチェックします. 神経学的検査 – ビジョンをチェックします, バランス, コーディネーション, 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 – 例えば, by stopping the use of a particular medication or treating an infection.
治療は、身体を癒すための最高の環境を作成し、脳を落ち着かせるに焦点を当てて.

  • 支持療法
  • 支持療法はで合併症を予防することを目指して:
  • 気道を守ります
  • 痛みの治療
  • 失禁に対処します
  • 身近な人の家族の関与を奨励
  • 物理的制約および膀胱管の使用を避けます
  • 可能な場合は、周囲の変化や介護者の回避
  • 提供する流体および栄養
  • 運動を支援

医薬品
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 – 良い睡眠習慣を促進, 人を支援することは、十分に重視し、冷静さを保ちます, そして予防またはせん妄の重症度を軽減することができる他の医療問題を防ぐのに役立ちます.