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Management of Neurologic and Psychiatric Illness in the Patient with Heart Failure
Published in Andreas P. Kalogeropoulos, Hal A. Skopicki, Javed Butler, Heart Failure, 2023
Evangelos Pavlos Myserlis, Grigorios Kalaitzidis
The diagnosis of delirium is primarily based on clinical evaluation. When a patient presents with confusion, it is important to determine the onset of this change in cognitive function and whether there is fluctuation in the disease state. The baseline cognitive function of the patient can be evaluated by information from caregivers, if no other recent formal assessment exists. An acute decline in cognition suggests delirium and the patient should be promptly assessed for delirium precipitants, including a potential HF exacerbation. Overview of the medications received and evaluation for potential side effects should not be omitted from the diagnostic process. If no history can be obtained, the patient should be considered delirious until proven otherwise.
Diagnosis of Dementia
Published in Dawn Brooker, Sue Lillyman, Mary Bruce, Dementia Care, 2023
Dawn Brooker, Sue Lillyman, Mary Bruce
A full history should rule out causes of delirium (acute confusion), such as infections, nutritional state, vitamin deficiency, thyroid problems, depression and side effects of medication; other mental health problems, such as depression; and other causes of neurological impairment.
Communication: a person-centred approach
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
Acute confusion is usually defined as having a rapid onset and is characterised by changeable levels of consciousness often with an impaired ability to think and concentrate. NHS UK suggests that individuals who have sudden confusion (delirium) may have difficulty thinking or speaking clearly. They may feel disorientated and struggle to attend to their surroundings and some people also have hallucinations – seeing or hearing things that are not there (www.nhs.uk/conditions/confusion). Sudden confusion can be caused by a number of conditions for example low blood sugar, some medications, infection, alcohol or head injury. It is therefore crucial that thorough assessment is carried out and ensuring appropriate communication skills are applied sensitively.
Safety of treatment options available for postoperative pain
Published in Expert Opinion on Drug Safety, 2021
Zhaosheng Jin, Christopher Lee, Kalissa Zhang, Tong J Gan, Sergio D Bergese
Delirium is an acute state of mental confusion and a prominent complication of postoperative pain, particularly in the geriatric population and those with preexisting cognitive impairment. Lynch et al performed an observational study examining how postoperative pain affects the development of postoperative delirium. They found an association between higher pain levels at rest and the development of delirium, suggesting that improving postoperative pain control may decrease the risk of delirium in postsurgical patients [5]. Data has shown that postoperative delirium is associated with a myriad of sequelae of its own, including prolonged hospital stay, greater risk of complications, increased mortality, and higher chance of discharge to a long-term care facility [6,7]. Patients at risk of developing delirium should be screened at least daily with the Confusion Assessment Method (CAM) algorithm [8].
Recovery after volleyball: a narrative review
Published in The Physician and Sportsmedicine, 2020
Brian Closs, Connor Burkett, Jeffrey D. Trojan, Symone M. Brown, Mary K. Mulcahey
Additionally, the so called ‘home court advantage’ may be partially attributable to improved sleep, as volleyball players tend to have lower sleep quality and increased nocturnal awakenings the night before away games compared to the night before home games or training days [27]. In 2016, Andrade et al. administered sleep and mood questionnaires to volleyball players 30 minutes before their matches began [28]. The questionnaires measured tension and confusion levels in relation to both sleep quality and match outcomes. Confusion was defined as a combination of unusual responses to anxiety and/or depression, feelings of uncertainty, and inability to control emotions. The authors found that players with poor sleep quality had higher levels of confusion compared to those with good sleep quality. Furthermore, players who subsequently lost their match reported significantly higher rates of confusion and tension, which are also related to poor sleep quality. The athletes who slept well and won their games were found to have lower stress levels [28].
Parental experiences of the diagnosis of permanent childhood hearing loss: a phenomenological study
Published in International Journal of Audiology, 2020
Dunay Schmulian, Christopher Lind
1. Confusion, which we define as uncertainty about what is happening, or what is required was identified by all participants as one of the initial emotions they experienced. Participant 7a states that, at the diagnosis of profound bilateral hearing loss and when complex anatomical anomalies were identified during the early management process:“We got confused……until now we [were] still confused….less confused in terms of information, but more confused in term of what we should do next.” Participant 7a“It was confusing, so it was very confusing to know what to do, so it was all the ins and outs, I didn’t know what to do.” Participant 6b