Delirium Essay Example

Explain the diagnostic criteria for your assigned neurocognitive disorder.
Explain the evidenced-based psychotherapy and psychopharmacologic treatment for your assigned neurocognitive disorder.
Identify the risks of different types of therapy and explain how the benefits of the therapy that might be achieved might outweigh the risks.
Support your rationale with references to the Learning Resources or other academic resource.  Delirium Essay Example

Delirium

Delirium is a serious problem in acute healthcare settings. Delirium indicates vulnerability and is allied to adverse health outcomes. According to the European Delirium Association & American Delirium Society, 2014,) delirium represents a decompensation of cerebral function in response to pathophysiological stressors or a medical condition. Therefore, accurate diagnosis of delirium can is essential in identifying acute illness in patients. The pathophysiology of delirium involves the multifaceted interrelationship between a susceptible individual and exposure to triggering factors.

According to the DSM-5 diagnostic criteria, delirium is characterized by disturbance in attention as manifested by confusion, decreased awareness and reduced ability to focus, sustain and change attention; cognition disturbance as manifested by memory deficit, language and perception deficit; and the history, laboratory findings or physical examinations indicate that the disturbance is as a result of a medical condition, exposure to toxins or substance intoxication or withdrawal symptoms (European Delirium Association & American Delirium Society, 2014).

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Psychotherapy and Psychopharmacologic Treatments

There is always a medical cause for delirium. Therefore, the initial treatment goal for delirium is addressing the underlying cause of delirium. Afterward, the treatment focuses on establishing the best atmosphere for healing the body and relaxing the brain.

Environmental interventions have been shown to reduce the risk and symptoms allied to delirium. These symptoms improve distorted thinking, sleep disturbances, disorientation, sensory deprivation, and can address other environmental aspects (Sánchez-González et al., 2016). Examples of environmental interventions include engaging patients in activities that stimulate them mentally to assist with distorted thinking; orient the patient to familiar people and materials; reduce the number of individuals interacting with the patient; use family members to reassure or reorient the patient; and use of physical restraints in case it is necessary to ensure safety in patients with severe agitation (Irwin et al., 2015).  Delirium Essay Example

Supportive care for individuals with delirium includes promoting sleep and rest by decreasing distraction and noise; reassuring the patient; keeping the patient calm oriented; explaining to the patient what is going on; and preventing medical problems and complications by administering medication on regular schedule, keeping the patient hydrated and providing healthy diet; promoting and encouraging regular physical activity; and seeking treatment promptly for potential problems such as metabolic imbalances and infections (Sánchez-González et al., 2016).

The psychopharmacologic treatments for delirium include antipsychotic medications to treat symptoms such as hallucinations, agitation, and to improve sensory problems. The most commonly used antipsychotics include Haloperidol, Olanzapine, Risperidone, and Quetiapine (Weiss &Scheeringa, 2014). After symptom improvement, the medication should be withdrawn gradually and not suddenly to prevent withdrawal symptoms.

The benzodiazepines are also used to treat delirium in patients with drug or alcohol withdrawal. The benzodiazepines work as sedatives, skeletal muscle relaxants, potent antiepileptics, anxiolytics, and amnestics. Patients should be administered with the minimum benzodiazepine dose required to fast and safely relieve delirium symptoms. In case the patient experience a paradoxical reaction and they start manifesting increased agitation, it is necessary to increase the dose in order to overcome the paradoxical reaction and relieve the symptoms, without any unwanted side effects (Sánchez-González et al., 2016).

References

European Delirium Association, & American Delirium Society (2014). The DSM-5 criteria, level of arousal and delirium diagnosis: inclusiveness is safer. BMC medicine, 12(141).

Irwin, S. A., Pirrello, R. D., Hirst, J. M., Buckholz, G. T., & Ferris, F. D. (2015). Clarifying delirium management: practical, evidence-based, expert recommendations for clinical practice. Journal of palliative medicine, 16(4), 423–435.

Sánchez-González, Roberto & Bailles, Eva & Bastidas Salvadó, Anna & Pintor, Luis. (2016). Psychopharmacological treatment of patients with delirium referred to a consultation-liaison psychiatry service. European Neuropsychopharmacology, 26(1), S754-S755.

Weiss A &Scheeringa MS. (2014). Psychopharmacological treatment of delirium: does earlier treatment and scheduled dosing to improve outcomes? J La State Med Soc,166(6), 242-7.  Delirium Essay Example

 

 

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