Zifukwa, Zoopsya, Kuzindikira ndi Chithandizo cha Delirium
Mwachidule
Odwala ambiri amasokonezeka atatha opaleshoni, koma delirium ndi mtundu wina wa chisokonezo chomwe chikhoza kuchitika kuchipatala komanso panthawi ya kuchipatala . Ngakhale delirium amachititsa chisokonezo, chisokonezo chonse sichimachitika ndi delirium.
Delirium ndi chisokonezo chomwe chimapezeka mwadzidzidzi. Nthawi zambiri zimakhala zowawa kwambiri m'chilengedwe - akadziwidwa ndi kuchiritsidwa, wodwalayo amabwerera ku msinkhu wawo woganiza.
Wodwala yemwe akusokonezeka tsiku ndi tsiku adzasokonezeka kwambiri, ndipo nthawi zambiri, adzabwerera ku msinkhu wawo wa chisokonezo mutatha kulandira.
Zowopsa
Ngakhale aliyense atha kukhala ndi zokondweretsa, magulu ena amatha kukhala ndi chipatala kuchipatala. Mbadwo umasewera mbali, koma kuopsa kwa matenda omwe akudwala, wodwalayo ali ndi chiwerengero cha ntchito tsiku ndi tsiku komanso thanzi la wodwalayo limasewera gawo.
- Okalamba ndi akuluakulu
- Anthu omwe ali ndi matenda a m'mimba, Matenda a Alzheimers kapena mtundu wina wa matenda a maganizo omwe amachepetsa kulingalira bwino kapena kusokoneza
- Anthu omwe ali ndi vutoli
- Odwala opaleshoni
- Odwala ICU, odwala odwala
- Odwala okhala ndi zipatala zambiri
- Mankhwala ena
Monga momwe mungaganizire, wodwala wachikulire yemwe ali ndi chifuwa chachikulu cha umphawi amene amafunikira chisamaliro chokwanira ali pachiopsezo chachikulu kuposa mwana wamkulu yemwe alibe zifukwa zowonjezera zomwe ali m'chipinda chapadera kuchipatala.
Mankhwala osamalira kwambiri , makamaka, amakhala osokonezeka kwambiri pa nthawi yogona / kupuma, monga momwe odwala akukumana ndi zizindikiro zofunika, nthawi zambiri mankhwala, nthawi zambiri amatembenuka, akulandira mankhwala ambiri ndipo nthawi zambiri amakhala m'chipinda chowala kwambiri . Pachikhalidwe chimenecho mukhoza kumva delirium wotchedwa "ICU Psychosis."
Amakonda kwambiri akuluakulu komanso okalamba koma angathe kuchitika m'badwo uliwonse. Zimakhalanso zofala kwambiri kwa anthu omwe ali ndi vuto linalake laumoyo pamoyo wawo tsiku ndi tsiku, monga dementia.
Okalamba achikulire omwe ali ndi matenda a 'dementia' amakhala ndi chiopsezo chachikulu chodziwidwa mwadzidzidzi m'maganizo awo ali kuchipatala.
Zizindikiro Zakale
Pambuyo pa wodwala asanasonyeze zizindikiro za delirium, pali njira yoyamba yomwe odwala amatha kukhala ndi maola ambiri kapena ngakhale masiku oyambirira. Panthawiyi, odwala akhoza kulongosola maloto omveka bwino, kuvutika kugona, mantha aakulu kapena nkhawa zomwe sizidalipo kale, ndipo angayambe kupempha kukhalapo kwa wina m'chipinda chawo.
Kufotokozera zizindikirozi kumayambiriro kungatanthawuze kuti mutha kulowapo ndipo mutha kulepheretsa wodwalayo kuti asaphedwe bwino m'masiku omwe akubwera.
Zizindikiro
Palibe chiyeso cha delirium, sichikhoza kupezeka kudzera mu labata, chiyenera kupezedwa mwa kuyang'ana khalidwe la wodwalayo ndikudziwunikira ngati khalidwe lawo likugwirizana ndi matenda a delirium.
Kuzindikira delirium kungakhale kovuta chifukwa kungakhale kosiyana kwambiri ndi odwala mpaka opirira.
Mwachidziwikire, anthu omwe ali ndi delirium akhoza kukhala ovuta kuganizira pa mutu umodzi, kawirikawiri amaoneka ngati osokonezeka ndipo nthawi zambiri amakhala ndi chidziwitso chochepa.
Kukhumudwa kwawo ndi kuvutika kwawo kumakhala kovuta usiku, zomwe zimatchedwa "sundowners" kapena "sundowning".
Mafilimu ndi Mafilimu
Anthu awa akhoza kukumana ndi zinyengo ndi zolinga. Kusokoneza ndi chikhulupiliro chonyenga chochitidwa ndi munthu. Mwachitsanzo, wodwala ndi delirium angakhulupirire kuti namwino akuyesera kuwapha, kapena tizilombo timayambira pamabedi awo.
Hallucinations ndi chisokonezo cha maso. Wodwala amatha kuona mabomba akuuluka mozungulira chipinda ndikuwoneka akuuluka kuchokera pakona kupita ku ngodya. Iwo akhoza kuyesetsa ndi kuyesa kugwira chinachake chimene sichipezekapo, kapena kuyankhula ndi winawake yemwe palibe kapena ngakhale munthu amene wamwalira.
Zizindikiro Zamthupi
Mwachibadwa, wodwalayo nthawi zambiri samatha kugona tulo, ndipo angayambe kukhala ndi vuto ndi kumeza, kulankhula momveka bwino komanso momveka bwino, ndipo akhoza kuyamba kunjenjemera chifukwa chosadziwika.
Zizindikiro ndi zizindikirozi zimayenera kutengedwa ngati gulu, osati payekha. Munthu yemwe amadwala mwangozi mwina alibe delirium, koma wodwala yemwe sangathe kukhala chete, sangakhoze kumeza, akuwona mbalame m'chipinda chawo chachipatala ndipo sanagonepo masiku angapo amachita.
Mitundu
Deliriamu akhoza kupereka monga mtundu wopitirira muyeso wa delirium kapena mtundu wosagwira ntchito. Mankhwala osokoneza bongo amachititsa kusokonezeka, wodwala akhoza kukhala maso kwambiri mpaka kufika polephera kugona kwa masiku, ndipo zingawoneke ngati ali otcheru kwambiri. Iwo angawoneke kuti "akudumpha" kapena samakhala chete, ngati kuti ali ndi caffeine kwambiri kuti agone. Khalidwe limeneli nthawi zambiri limakhala losamvetsetseka pa nkhani ya chipatala chawo - iwo amakhala maso pamene wina angafunike kupuma mokwanira.
Odwala a hypoactive delirium angaoneke ngati otsika, otopa kwambiri kuti asamalimbikitse ntchito, akuvutika maganizo, ogona, ndipo sangathe kukambirana. Mtundu uwu nthawi zambiri zimakhala zovuta kusiyanitsa ndi kudwala ndi kutopa kusiyana ndi mtundu wogwira ntchito.
Chifukwa Chake Zimagwirizana Pambuyo Pa Opaleshoni
Delirium amawonedwa kawirikawiri pa odwala opaleshoni kusiyana ndi anthu ambiri a chipatala chifukwa cha zifukwa zingapo, amakhala odwala kuposa oposa onse, amalandira mankhwala a anesthesia omwe angapangitse kuti apereke mankhwala, akhoza kukhala ndi chipatala chokwanira ndipo angalandire mankhwala opweteka nthawi kupuma kwawo ndi mankhwala ena omwe angawononge kwambiri delirium.
Chithandizo
Kuwonjezera pothandiza wodwala kupeza ubwino wa ubwino umene amafunikira kwambiri, odwala omwe ali ndi delirium amafunikanso kuthandizira kusamalira zofunika ndi zofunika zomwe sangathe kuzigwira pokudwala.
Pamene wodwalayo ali ndi delirium, nkofunika kuti ogwira ntchito kuchipatala (komanso achibale ndi abwenzi omwe angayende) amathandiza kupereka wodwalayo zinthu zofunika zomwe akufunikira kwambiri. Izi zimaphatikizapo kugona kosasokonezeka, kudya ndi kumwa nthawi zonse, kusamalira zosowa zapanyumba ndikusintha nthawi zonse wodwala wosokonezeka.
Kusintha mobwerezabwereza kumatanthauza kungololera modzichepetsa kuti wodwala adziwe kuti ali m'chipatala, chifukwa chake ali pomwepo komanso tsiku ndi nthawi yanji. Kwa achibale ndi abwenzi, ndikofunikira kuti musamakangane ndi wodwala yemwe akusokonezeka kapena akukumana ndi ziphuphu. Mungayesetse mwapang'onopang'ono kubwezeretsa wodwalayo kuti adziwe kumene ali ndipo chifukwa chake, koma kukangana kungangokwiyitsa wodwalayo komanso wachibale.
Ndikofunika kuti musamadzutse wodwalayo pamene akugona pokhapokha ngati chiri chofunikira kwambiri, ndipo antchito angasankhe kuchotsa chizindikiro chofunikira kapena pakati pa usiku usiku mankhwala omwe angayembekezere mpaka m'mawa ngati kumatanthauza kulola wodwala kugona. Maofesi ena amapereka makutu ndi masikiti a maso kwa odwala pofuna kuwonjezera ubwino wawo wa tulo mwa kutseka kunja kwa kuwala ndi phokoso.
Ngati wodwalayo sangadalire kuti akhale yekha popanda kuvulazidwa chifukwa chogona pabedi kapena ntchito zina, abambo, abwenzi, kapena ogwira ntchito kuchipatala ayenera kukhala m'chipinda nthawi zonse.
Mankhwala
Kudziwa chomwe chimayambitsa Delirium ndicho chofunikira kwambiri pa chithandizo. Ngati mankhwala akuyambitsa vutoli, lekani. Ngati musiye kumwa mowa , mankhwala osokoneza bongo kapena mankhwala ndi vuto, muzilitseni. Ngati vuto lalikulu la kugona ndilo vuto, chithandizo chimaphatikizapo kupereka malo abwino oti ogona ndi mankhwala azilimbikitsa kugona.
Mankhwala ogwiritsira ntchito mankhwalawa, monga Ramelteon (Rozerem), amaperekedwa kuti asamakhale kosavuta , pamene mankhwala ena monga Ativan angaperekedwe kuti achepetse chisokonezo ndi zizindikiro zilizonse zomwe zingachitike. Mankhwala a antipsychotic monga Haldol ndi Risperdal angagwiritsidwe ntchito, koma ayenera kupatsidwa mankhwala ochepetsetsa kwambiri kuti athetse kukhumudwa kwa wodwalayo.
Chitsime:
Postoperative Delirium mu Elderly: matenda ndi matenda. Ntchito Zothandizira Anthu Okalamba. Thomas Robinson ndi Ben Eiseman. Idapezeka mu January 2015. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2546478/