Nursing401

Delirium has been recognized as a serious acute medical condition that’s been called a medical emergency. Every day, 30,000 to 40,000 ICU patient in the United States are suffering from acute brain dysfunction called delirium (Maniou, 2012). Delirium is a manifestation of CNS dysfunction, it is important to recognize and treat life-threatening conditions that may result in delirium such as; sepsis, pneumonia, myocardial infarction, pulmonary embolism and medications. It’s recommended that after nurses’ exclude life-threatening complications that they turn their attention to the patients environment and make attempts to minimize any factors that may exacerbate delirium such as; avoiding prolonged sleep deprivation, minimizing artificial lighting, and being mindful of clustering patient care to avoid additional disruptions.

Patients on mechanical ventilation increase the risk of delirium three-fold. It has been found that the mortality rate with patients experiencing delirium may exceed twice the six-month mortality rate of nondelirious patients, and it is associated with longer hospital stays and with a higher rate of cognitive impairment at discharge (Maniou, 2012). CAM-ICU is a useful tool in diagnosing and monitoring delirium and is recommended to be used frequently in the ICU, it is constructed with yes/no questions for use with nonspeaking, mechanically ventilated ICU patients. To reduce the length of time patients spend heavily sedated and immobilized on a ventilator healthcare providers are awakening patients from sedation earlier, assessing pain, and getting them to breathe on their own as soon as possible to avoid prolonged delirium which can have long lasting effects on cognitive function. Focus is also aimed at getting patients up and moving while still on a ventilator can also help reduce muscle weakness and assist in a speedier recovery.

References:

Landro, L. (2011). Informed patient: changing sedation status quo in the ICU.  Health Blog, Wall Street Journal. Retrieved from http://blogs.wsj.com/health/2011/02/15/changing-the-sedation-status-quo-in-the-icu/

Maniou, M. (2012). Delirium: a distressing and disturbing clinical event in a intensive care unit. Health Science Journal, Vol 6, Issue 4.