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Adult Nursing PracticeUsing evidence in care$
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Ian Bullock, Jill Macleod Clark, and Joanne Rycroft-Malone

Print publication date: 2012

Print ISBN-13: 9780199697410

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780199697410.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 18 January 2022

Managing Delirium and Confusion

Managing Delirium and Confusion

(p.285) 17 Managing Delirium and Confusion
Adult Nursing Practice

Emma Ouldred

Catherine Bryant

Oxford University Press

This chapter focuses on the assessment, management, and diagnosis of delirium, one form of confusion that commonly presents in healthcare settings. It will equip you with the skills required to differentiate between dementia, delirium, and depression through comprehensive assessment, and will improve the confidence of practising nurses in the management of this debilitating condition. This chapter will help you to select and implement evidence-based strategies to manage patients presenting with confusion regardless of the cause of confusion, such as dementia (see Chapter 7 Understanding Dementia). Confusion is derived from the Latin verb confundere, meaning ‘to mingle’. It is a descriptive term that has a variety of different definitions. It has been defined as a disturbance of consciousness characterized by impaired capacity to think clearly and with customary rapidity, and to perceive, respond, to, and remember current stimuli, and some degree of disorientation (Faber and Faber, 1953). Disorders causing confusion can be categorized into three groups:…● acute disorders usually associated with acute illness, drugs, and environmental factors; ● more slowly progressive impairment of cognitive function, such as that seen in dementia syndromes; ● impaired cognitive function associated with affective disorders and psychoses such as depression….Regardless of aetiology, confusion can be very distressing for the person exhibiting these symptoms, his or her relatives and carers, and for health and social care practitioners. It is important to differentiate between different causes of confusion for appropriate treatment plans to be developed. The word delirium is derived from Latin, meaning ‘off the track’, and is often referred to as acute confusional state. Delirium is a common and distressing disorder associated with increases in physical morbidity, length of hospital stay, and entry to long-term care, and therefore increases in cost to health services. However, it can be prevented and treated if dealt with urgently (National Institute for Health and Clinical Excellence (NICE), 2010a). The Diagnostic and Statistical Manual of Mental Disorders, 4th edition text revision (DSM-IV TR), is used by clinicians and psychiatrists to diagnose psychiatric illnesses.

Keywords:   alcohol withdrawal, benzodiazepines, delirium, hyperactive delirium, mixed delirium, olanzapine

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