STUDY - Technical - New Dacian's Medicine
Confusion
(Classical / Allopathic Medicine)
An umbrella term
for puzzling or inappropriate behavior or responses, confusion
is the inability to think quickly and coherently. Depending on
its cause, confusion may arise suddenly or gradually and may
be temporary or irreversible. Aggravated by stress and sensory
deprivation, confusion often occurs in hospitalized patients -
especially elderly patients, in whom it may be mistaken for
senility.
When severe
confusion arises suddenly and the patient also has
hallucinations and psychomotor hyperactivity, his condition is
classified as delirium. Long-term, progressive confusion with
deterioration of all cognitive functions is classified as
dementia.
Confusion can
result from a fluid and electrolyte imbalance or hypoxemia due
to a pulmonary disorder. It can also have a metabolic,
neurologic, cardiovascular, cerebrovascular, or nutritional
origin or can result from a severe systemic infection or the
effects of toxins, drugs, or alcohol. Confusion may signal to
worsening of an underlying and, perhaps, irreversible disease.
HISTORY:
Ask the patient to describe what's bothering him. He may not report confusion as his chief complaint but instead may complain of memory loss, persistent apprehension, or inability to concentrate.
If the patient is unable to respond logically to direct questions, check with his family about the onset and frequency of the confusion.
Review the patient's medical history for head trauma or a cardiopulmonary, metabolic, cerebrovascular, or neurologic disorder.
Obtain a drug history, including prescription and over-the-counter drugs, herbal remedies, and recreational drugs. Also, ask the patient about alcohol intake.
Ask the patient about changes in eating or sleeping habits.
Ask the patient to describe what's bothering him. He may not report confusion as his chief complaint but instead may complain of memory loss, persistent apprehension, or inability to concentrate.
If the patient is unable to respond logically to direct questions, check with his family about the onset and frequency of the confusion.
Review the patient's medical history for head trauma or a cardiopulmonary, metabolic, cerebrovascular, or neurologic disorder.
Obtain a drug history, including prescription and over-the-counter drugs, herbal remedies, and recreational drugs. Also, ask the patient about alcohol intake.
Ask the patient about changes in eating or sleeping habits.
PHYSICAL
ASSESSMENT:
Check the patient's vital signs, and assess the patient for changes in blood pressure, temperature, and pulse.
Perform a neurologic assessment to establish the patient's level of consciousness. Also, perform a Mini–Mental Status Examination.
Check the patient's vital signs, and assess the patient for changes in blood pressure, temperature, and pulse.
Perform a neurologic assessment to establish the patient's level of consciousness. Also, perform a Mini–Mental Status Examination.
SPECIAL
CONSIDERATIONS:
Never leave a confused patient unattended; this will help prevent injury to himself and others. Keep the patient calm and quiet, and plan uninterrupted rest periods. Remember that herbal medicines, such as St. John's wort, can cause confusion, especially when taken with an antidepressant or other serotonergic drugs.
Never leave a confused patient unattended; this will help prevent injury to himself and others. Keep the patient calm and quiet, and plan uninterrupted rest periods. Remember that herbal medicines, such as St. John's wort, can cause confusion, especially when taken with an antidepressant or other serotonergic drugs.
PEDIATRIC
POINTERS:
Confusion can't be determined in infants and young children.
Older children with acute febrile illnesses commonly experience transient delirium or acute confusion.
Confusion can't be determined in infants and young children.
Older children with acute febrile illnesses commonly experience transient delirium or acute confusion.
PATIENT
COUNSELING:
Advise the family to help orient the confused patient by keeping a large calendar and clock visible and that making a list of his activities with specific dates and times also helps.
Advise the family to help orient the confused patient by keeping a large calendar and clock visible and that making a list of his activities with specific dates and times also helps.
Bibliography:
1. Rapid Assessment, A
Flowchart Guide to Evaluating Signs & Symptoms, Lippincott
Williams & Wilkins, 2004.
2. Professional Guide to
Signs and symptoms, Edition V, Lippincott
Williams & Wilkins, 2007.
3. Guide to common
symptoms, Edition V, McGraw - Hill, 2002.
Dorin,
Merticaru (2010)