Wat is Delirium

Delirium is een ernstige verstoring van de cerebrale capaciteiten die resulteert in verward denken g en verminderde bewustzijn van je lokale omgeving. De ster van het delirium is tot snelle, die binnen een uur of een paar dagen.
Delirium kan vaak worden herleid tot één of meer bijdragende factoren, zoals ernstige of chronische medische ziekte, verschillen in de metabole balans ( zoals zoutarm), infectie, geneesmiddel, chirurgie, or alcohol or drug withdrawal.
Because symptoms of delirium and zwakzinnigheid 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.
  • Being withdrawn, with little or no activity or little reply to the environment.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, bijvoorbeeld, 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 (hallucinaties)
  • 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:

  • Angst, fear or paranoia
  • Depressie
  • Irritability or anger
  • A sense of feeling elated (euphoria)
  • Apathy
  • Radpi and unpredictable mood shifts
  • Personality changes

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. 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.

Wanneer een arts te zien.
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, is van essentieel belang voor een juiste diagnose en voor een diner van de onderliggende oorzaak.
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.

Oorzaken
Fever occurs when the standard sending and receiving of signals in the brain become impaired. Deze stoornis waarschijnlijk veroorzaakt door een mengsel van factoren die de hersenen kwetsbaar en leiden tot storing van hersenactiviteit.

Delirium kan een enkele oorzaak of meerdere oorzaken hebben, zoals een medische conditie en medische toxiciteit. Soms zijn er geen omstandigheden die genoemd worden

Mogelijke oorzaken zijn:

  • Alcohol- of drugsmisbruik of intrekking
  • Een medische toestand
  • Bepaalde medicijnen of drugs toxiciteit
  • metabole onbalans, 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
  • Pijn

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, en depressie
  • Parkison diseases

Risicofactoren

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’ ziekte

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.

De mate van herstel hangt in zekere mate af van de gezondheid en mentale toestand voor het begin van delirium. Bijvoorbeeld, mensen met dementie ervaren een aanzienlijke algemene daling in het denken vaardigheden en het geheugen. De mensen in een betere gezondheid hebben meer kans om te herstellen.

Mensen . met andere ernstige, chronische of terminale aandoeningen is misschien niet de niveaus van denken vaardigheden of functie die zij hadden voor de toestand van delirium herwinnen. Delirium is serieuze mensen is meer waarschijnlijk leiden tot:

  • Slechte herstel na een operatie
  • Behoefte aan institutionele zorg
  • 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, het denken, and attention. This may be accomplished informally through conversation, or with test or screening that assess the mental state, verwarring, perceptie, 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, saldo, coördinatie, 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 – bijvoorbeeld, 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

medicijnen
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. Als gevolg van de invasieve procedures, luid geluid, frequente kamer veranderingen, weinig licht en het gebrek aan daglicht kan verwarring verergeren.
Evendicne geeft aan dat deze strategieën – 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.