...MANAGEMENT OF DELIRIUM IN THE ICU Colleen Gottlieb Erica Powell Mary Tool July 16, 2013 **think this has to be double spaced Management of Delirium in the ICU Introduction Delirium is a serious condition that can affect patients in and outside the hospital. With its presence being unknown to many nurses and providers, delirium has significant long term complications that can last well beyond discharge. Noise, medication, and infection are significant in the development and progression of delirium and these are more than abundant within intensive care patients. The importance of nurse’s knowledge cannot be stressed enough regarding the assessment, symptoms, and interventions of delirium, in an effort to decrease its occurrence and the implications thereafter. With the proper assessment and improved nursing interventions, data should display an increase in patient safety, decrease in prevalence, and reduce costs related to longer hospital stays. The state of being delirious occurs with a sudden decrease in a patient’s level of consciousness. It may be accompanied by inattention directly related to the care being given or by a change in cognition. (cite AACN practice alert) There are a variety of possible causes of delirium. These causes include: alcohol withdrawal, sepsis, pneumonia, electrolyte imbalances, liver failure, encephalitis, head trauma, meningitis, the use of many medications and abrupt withdrawal of medications. Most medical diagnosis and their possible...
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...Much of the existing literature and advancing scientific knowledge on delirium focuses on understanding the physiological process of delirium. The gap in the literature is in the research into prevention of delirium. If practitioners were to know the trajectory of delirium over time, they could more adequately implement treatment. Accordingly, this research will advance the body of knowledge on the topic by focusing on a group of symptoms and tools that represent changes in an individual’s level of consciousness and thinking over a designated period. This designated time is the period of maximal onset of the process of delirium in the intensive care environment. In addition to addressing the gap in the literature, the research will focus on...
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...Nursing 122 Fundamentals of Neuro-Sensory nursing --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- Review major structures and functions of both central and peripheral nervous system. (Carolyn Jarvis, Physical Examination and Health Assessment, 3rd ed., pages 688-692 Structure and function of the CNS and PNS --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- Potter and Perry, Fundamentals of nursing (8th), Chapter 16 p. 210-211 Types of Data --There are two primary sources of data: subjective and objective. Subjective data are your patients’ verbal descriptions of their health problems. Only patients provide subjective data. For example, Mr. Jacobs's report of incision pain and his expression of concern about whether the pain means that he will not be able to go home as soon as he hoped are subjective findings. Subjective data usually include feelings, perceptions, and self-report of symptoms. Only patients provide subjective data relevant to their health condition. The data sometimes reflect physiological changes, which you further explore through objective data collection. --Objective data are observations or measurements...
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...SLO Week 14 Spring, 2015 14 SLO: Older Adult OBJECTIVES 1. Identify common myths and stereotypes about older adults. 2. Identify selected biological and psychosocial theories of aging. 3. Discuss common developmental tasks of older adults. 4. Describe common physiological changes of aging. 5. Differentiate among delirium, dementia, and depression. 6. Discuss issues related to psychosocial changes of aging. 7. Describe selected health concerns of older adults. 8. Identify nursing interventions related to the physiological, cognitive, and psychosocial changes of aging. Joseph Lawrence, a 78-year-old retired attorney, was admitted to the hospital with chest pain that was diagnosed as a myocardial Infarction. He was treated with a stent 2 days ago. He has a history of hypertension. He is active and plays golf twice a week with a group of friends. He is married and has a daughter who lives out of town. His wife has been at the hospital with him constantly. He is now pain free and is ready to go home. Katy Summers is a nursing student assigned to Mr. Lawrence today. 1. ------------------------------------------------- Katy is to first determine whether Mr. Lawrence is meeting the development tasks for an older adult. Which of the following would Katy use to determine this? Select all that apply. A. ------------------------------------------------- He has adjusted to retirement. B. He maintains satisfactory living arrangements...
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...We’ve been in class for about two months now and I feel like I’m not picking up the new signs as fast as I was last semester. However, the class this semester is very different from how it was ran last semester. I understand that it’s a different class and that it’s supposed to be harder, but all it’s been is confusing. I’m still not a fan of the packets we’re supposed to do in class because sometimes the terms will be missing or the action will be doubled. It tends to be confusing and takes a lot of time to finish up. I am kind of upset that my professor didn’t have us do video assignments this time around. I felt like those helped a lot when it came learning and reviewing the material more. The slides also tend to be confusing as well, maybe I’m just a confused person, but they seem to be very scattered and not well organized. Also, the terms not being listed at the end of the slides makes it difficult to remember them. I know personally, I write everything down so I can look at it later on and try to memorize them, but that’s hard to do when once I finish writing on word down, we’re onto the next one and I miss the sign completely. Other than that, I’m very excited and nervous about this video project. I feel like it’s going to determine how much we’ve actually learned these past two months and how much we’ve actually committed to memory. So I can’t wait to see that. I think the number of deaf event papers we have to write is a bit unfair considering most of us don’t...
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...Dos and don’ts of academic writing |Aspect |Do this |Don’t do this | |Position |Be even-handed, considering all sides of |Show bias, looking at only one viewpoint. | | |question. | | |Statement of position |Use a thesis statement to introduce the |Jump straight into argument without creating a | | |direction you will take. |context for that argument. | |Statement of scope |Clarify what issues are to be covered, and what |Avoid statement of scope. | | |will not be covered. | | |Terminology |Define terms; if technical terms need to be |Avoid defining terms; switch between normal and | | |used, explain them in first instance. |technical language without notice. | |Exposition of argument |Clearly set out paragraphs; use headings where |Avoid clear topic changes with paragraphing; use | | |appropriate; use...
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...Tom’s confusing Role: In 1990, Tom changed his job title from being a ‘managing director’ to ‘executive software designer’. On one hand he did not want own up to managerial responsibilities and on the other he still wanted to exercise the right to supervise the directors. This mismatch of roles confused the employees about Tom’s position at Serendipity and should’ve given Anne an early sign of the buyout. In 1991, after Rick Delaney, Tom’s nominal boss was fired; Tom still refused to take the position of the software development director. Anne over-burdened: Anne played a pivotal role in the success of Serendipity. Due to her networking with people (letters to her previous employer) and her unrelenting spirit, the company had great business opportunities. She single-handedly managed Serendipity and also adopted the role of promoting it by giving presentations at trade-shows and conferences and writing articles for computer publications. Even though she never complained, we still believe that she had more than she should’ve handled. Tom’s misbehavior with colleagues: While Tom’s marriage was ending, he was accused of sexually harassing employees. Alan Perkins, the director of marketing in agreement with two other directors, filed these incidents and Tom was warned. With the spread of this news there was chaos in the organization, however, Tom described it as a “supportive act”. Anne realized that this could have repercussions and Serendipity could be sued. However, Tom felt...
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...Delirium in the Older Adult Population Delirium is a common issue found in older adults in the hospital and often not recognized until the illness develops, showing more evident and severe symptoms. Delirium is most commonly seen in the intensive care unit (ICU) and its frequency suggests an evident need for increased prevention. This paper will review an article by Susan Seliger, Another Hospital Hazard for the Elderly (see Appendix for more information), and look at various other perspectives focussing on the main arguments, as well as looking at personal understandings and biases, to better relate to and work with delirious older adults. Summary of the Article To summarize Susan’s article, “Another Hospital Hazard for the Elderly”, it...
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...Testing of the Product For the testing of the product, I asked 5 people who are my target audience and another person who is a keen badminton player. For the 5 people, I uploaded the product on the computer and asked each person to spend time viewing the product and doing the quiz. For the keen badminton player, I had to email him the quiz with the relevant videos and animations and also a questionnaire which to be completed after he viewed the product. All the people had to complete the questionnaire, where they could give their opinion on the product and also ways of improving the product. The feedback which I got from the target audience is that the product overall is educational and that the information given on each page was the right amount. The users also commented on the videos, they believed that the videos form the techniques section was a good idea of for the users to actually visualize the shot and that they will be more likely to understand how to do the shots and will be able to do it themselves. Another user also commented on the rollover buttons which are on the menu page; they thought that it was an interesting feature to the product. Also they said that the navigation of the product was easy as I had every button on each page which made it easy for them to look at different pages without them going back to the menu page. Improvements to be made from the feedback: One of the test users stated out that I have included a smash shot on the introduction animation;...
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...onfusion Madi 2.1.15 FDENG 101 Confused: To Be or Not To Be? Confusion is inevitable. It’s bound to happen at sometime whether I’m at the grocery store wondering where everything is since management thought it would be a good idea to put me out of my comfort zone, or driving by a strange new place that I’ve never seen before. Confusion could really hit at any time. Life as a whole is a bunch of years jumbled up into one long, confusing mess. With so many different options of what to believe, who to trust, what foods to like, or what I am comfortable doing, how do I not get confused? As confusing as it is, I love my life, but at the same time, why does it seem that I really ever know what’s going on? Okay, I am aware that virtually every college student is going through some oh-so-terribly-confusing time in their life. So why is it that I feel that nobody understands my confusion? Simply that. It’s mine, not anyone else’s. Since this uncertainty belongs to me and only me, why do I seem to think that my confusion trumps yours? Why do I feel that I am ultimately more important? I have always wondered that when see the color red, somebody else could be seeing what you think of as the color blue and just was always taught that this so-called blue color has and always will be called red? This has intrigued me since a young age, and I can’t seem to come to terms...
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...We often hear that it’s not unusual to be confused when you’re old. It’s true that we can expect many changes as part of normal aging. But a sudden change in cognitive function or the way we think and process information is not one of them ( 2016, U.S. Department of Veterans Affairs). When the confusion comes on suddenly, or the older adult becomes difficult to arouse, this could be a condition called delirium ( 2016, U.S. Department of Veterans Affairs). Delirium is an acute disorder of attention and cognitive in the elderly mostly those age 65 years or older (2013, Dr Meng-Chuan Lai, PhD). Contributing factors that can be traced to the causes of Delirium are chronic medical illness, changes in metabolic balance, medications, infection,...
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...stage symptoms in alcoholism clearly demonstrate the extent of the condition and how a person behaves when going through them. They include physical, psychological, behavioral and social symptoms that the person reveals in terms of control and some of the diseases that develop. Physical: there are biological changes which face the alcoholic in the late phase. The deteriorative or late phase of alcoholism is best recognized as the position at which bodily damage arising from the toxic consequences is evident. At this time, the alcoholic hosts a number of ailments (Rehm 138). The person may become extremely ill, destitute and mentally confused. Some of the diseases that present during the late alcoholism stage are epilepsy, diabetes and delirium tremens. In addition, due to constant drinking, the person may also suffer from liver cirrhosis, heart failure, malnutrition, brain damage, respiratory and fatty liver. Psychological: Alcohol addiction results in some serious psychological symptoms during the late stage. The patient at this time may have dementia and the fact that the person cannot be able to carry out daily operations without alcohol in their system (Rehm 139). As said earlier, in the first stage, the body is tolerant to alcohol, and in the second stage, the patient has to continue consuming alcohol minimize the withdrawal symptoms and the last change usually occurs without the knowledge of the person. Behavioral: during the late stage of alcoholism, there are some...
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...Alcoholism Bio/210 November 30, 2014 Alcoholism is an elusive condition. The American Medical Association labeled it as a disease in 1956 explaining that it has both mental and physical components. Alcoholics Anonymous declares alcoholics have a spiritual, physical, and, mental malady. Regardless, alcoholism affects around 14 percent of the U.S. population, and the consequences of its abuse can be fatal. Because alcoholism affects the whole body with symptoms including, depression, anxiety, cirrhosis, and heart failure, it is vital that researchers strive to find better treatment options, and legislation continues to protect the public from its devastating consequences. Alcoholism and Health Complications Physiology Alcoholism has reached epidemic proportions in the U.S. According to the Center for Disease Control and Prevention (2014), alcohol abuse contributed to 88,000 deaths in this country from 2006-2010. The health-related consequences can be short-term, including traffic accidents, alcohol poisoning, minor injuries, or sexually transmitted diseases. Many alcoholics, however, will suffer long-term chronic health conditions (Center for Disease Control and Prevention, 2014). In the cardiovascular system, excessive consumption strains the heart which may lead to irregular heartbeat, inflammation, and weakening of the heart muscle which puts the individual at risk for deterioration of the liver. High blood pressure as the result of a magnesium deficiency affects blood...
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...Alcoholism Emma Lattany NU250 Mental Health Instructor: Lori Barnes RN, BSN, LNC Alcoholism, is a destructive pattern of alcohol use that includes tolerance to or withdrawal from the substance (Dryden-Edwards, 2012). It is also known as alcohol dependence or alcohol addiction. Using alcohol longer than planned or having difficulty reducing its usage is a part of alcoholism. Alcoholism is not a chosen pattern of behavior but it is considered to be a disease. Those with alcoholism show signs of physical addiction to alcohol, but still continue drinking despite problems with physical and mental health. It also causes them problems with their social and family life as well as job responsibilities. Alcoholism may also take control over and alcoholic’s life and relationships. Some of the medical complications of alcoholism are: pancreatitis, cardiomyopathy, alcohol-related cirrhosis, and gastrointestinal bleeding. The use of alcohol on a daily basis has also been associated with many different types of cancers (Thompson, 2012). Alcohol use during pregnancy could lead to fetal alcohol syndrome which is a leading cause of mental retardation. Alcoholism is also linked to dementia, depression, suicide, accidents and homicide (Thompson, 2012). Alcoholism is the third most common mental illness and in the United States, more that 14 million people are affected by it (Dryden-Edwards, 2012). Alcoholism has a pattern of afflicting about 10% of men and 4% of women and costs...
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...TOP TEN CAUSES OF POISONING Section 2-D |Roña, Diandra Krystle B. | |Rosales, Aileen L. | |Rosaura, Franz D. | |Roxas, Marie Florence S. | |Rubio, Hannah Alexis O. | |Rugay, Jesus Emmanuel R. | February 1, 2012 POISONING Poisons are substances that cause disturbances in living organisms and do so by some biologic or chemical reaction in nature. For decades, the use of different substances for various applications lead to the discovery of potential toxic substances that may have caused injurious effects. Poisoning commonly occurs thru ingestion and usually, it was unintentional. Acute toxicity is the single exposure or multiple exposures for short periods to the substance causing the injury. Symptoms may be rapid and are in close relation to the toxic agent. On the other hand, chronic toxicity are caused by repeated or multiple exposure for longer periods to the poison. Signs and symptoms of chronic toxicity may appear even after several years upon the initial exposure. ADULT TOP TEN TOXICITIES 1. CAUSTICS Caustics are strong acids and alkali that when ingested can cause tissue injury by chemical reaction. They damage the tissues by accepting a proton (alkaline substance)...
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