Chapter 026 Confusion and Delirium (Part 4) pps
Chapter 026. Confusion and Delirium (Part 4) pps
... skin and soft tissue infections, sepsis CNS infections: meningitis, encephalitis, brain abscess Endocrinologic conditions Hyperthyroidism, hypothyroidism Chapter 026. Confusion and Delirium ... history and physical examination, while others require confirmation with laboratory studies, imaging, or other ancillary tests. A large, diverse group of insults can lead to delirium, and the ... patient's fluid status should be assessed; both dehydration and fluid overload with resultant hypoxia have been associated with delirium, and each is usually easily rectified. The appearance of...
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Chapter 026. Confusion and Delirium (Part 5) pps
... cause delirium, and mild derangements can lead to substantial cognitive disturbances in susceptible individuals. Other common metabolic etiologies include liver and renal failure, hypercarbia and ... deficiencies of thiamine and B12, autoimmune disorders including CNS vasculitis, and endocrinopathies such as thyroid and adrenal disorders. Systemic infections often cause delirium, especially ... to the unfamiliar environment of a hospital can lead to delirium. This etiology usually occurs as part of a multifactorial delirium and should be considered a diagnosis of exclusion after all...
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Chapter 026. Confusion and Delirium (Part 1) pdf
... Chapter 026. Confusion and Delirium (Part 1) Harrison's Internal Medicine > Chapter 26. Confusion and Delirium Confusion and Delirium: Introduction Confusion, a mental and behavioral ... delirium remain largely unknown and understudied. Some episodes of delirium continue for weeks, months, or even years. The persistence of delirium in some patients and its high recurrence rate ... terms are used to describe delirium, including encephalopathy, acute brain failure, acute confusional state, and postoperative or intensive care unit (ICU) psychosis. Delirium has many clinical...
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Chapter 026. Confusion and Delirium (Part 2) potx
... Chapter 026. Confusion and Delirium (Part 2) Epidemiology Delirium is a common disease, but its reported incidence has varied ... episode of delirium was viewed as a transient condition that carried a benign prognosis. Delirium has now been clearly associated with substantial morbidity and increased mortality, and is increasingly ... home, and are more likely to experience subsequent episodes of delirium; as a result, this condition has enormous economic implications. Pathogenesis The pathogenesis and anatomy of delirium...
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Chapter 026. Confusion and Delirium (Part 3) pptx
... 1990. History Chapter 026. Confusion and Delirium (Part 3) Approach to the Patient: Delirium As the diagnosis of delirium is clinical and made at the bedside, a careful history and physical ... autonomic instability, and changes in affect Table 26-1 The Confusion Assessment Method (CAM) Diagnostic Algorithm The diagnosis of delirium requires the presence of features 1 and 2 and of either ... Method (CAM) (Table 26-1); the Organic Brain Syndrome Scale; the Delirium Rating Scale; and, in the ICU, the Delirium Detection Score and the ICU version of the CAM. These scales are based on criteria...
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Chapter 026. Confusion and Delirium (Part 6) pdf
... evaluation Systemic infection screen Urinalysis and culture Chest radiograph Blood cultures Chapter 026. Confusion and Delirium (Part 6) LABORATORY AND DIAGNOSTIC EVALUATION A cost-effective ... Endocrinologic laboratories: thyroid-stimulating hormone (TSH) and free T4; cortisol and herbals) General physical examination and neurologic examination Complete blood count Electrolyte ... contraindications to magnetic exposure, many clinicians begin with CT scanning and proceed to MRI if the etiology of delirium remains elusive. Lumbar puncture (LP) must be obtained immediately,...
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Chapter 026. Confusion and Delirium (Part 7) potx
... Simple standard nursing practices such as maintaining proper nutrition and volume status as well as managing incontinence and skin breakdown also help to alleviate discomfort and resulting confusion. ... impairment, sleep deprivation, and dehydration. Significant reductions in the number and duration of episodes of delirium were observed in the treatment group, but unfortunately delirium recurrence rates ... commonly provokes delirium. Attempting to mimic the home environment as much as possible has also been shown to help treat and even prevent delirium. Visits from friends and family throughout...
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Chapter 023. Weakness and Paralysis (Part 4) pps
... on clinical grounds by the absence of spasticity and confirmed by EMG and nerve conduction tests. Chapter 023. Weakness and Paralysis (Part 4) Hemiparesis Hemiparesis results from an upper ... superior sagittal sinus or cortical venous thrombosis, and acute hydrocephalus. If upper motor neuron signs are associated with drowsiness, confusion, seizures, or other hemispheric signs, MRI ... helpful and refocus the subsequent evaluation. Subacute or chronic paraparesis with spasticity is caused by upper motor neuron disease. When there is associated lower-limb sensory loss and sphincter...
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Chapter 048. Acidosis and Alkalosis (Part 4) ppsx
... syndrome); (4) a decrease in the effective anionic charge on albumin by acidosis; or (5) hyperviscosity and severe hyperlipidemia, which can lead to an underestimation of sodium and chloride ... Steps in Acid-Base Diagnosis 1. Obtain arterial blood gas (ABG) and electrolytes simultaneously. 2. Compare [HCO3-] on ABG and electrolytes to verify accuracy. 3. Calculate anion gap (AG). ... plasma (normally 10 to 12 mmol/L) and is calculated as follows: AG = Na+ – (Cl– + HCO3–). The unmeasured anions include anionic proteins, phosphate, sulfate, and organic anions. When acid...
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Chapter 050. Hirsutism and Virilization (Part 4) ppsx
... particularly SHBG; (3) impairment of the peripheral conversion of androgen precursors to active androgen; and (4) inhibition of androgen action at the target tissue level. Attenuation of hair ... the steps in the pathway of androgen synthesis and action: (1) suppression of adrenal and/ or ovarian androgen production; (2) enhancement of androgen-binding to plasma-binding proteins, particularly ... hyperandrogenism. Because adrenal androgens are readily suppressed by low doses of glucocorticoids, the dexamethasone androgen-suppression test may broadly distinguish ovarian from adrenal androgen...
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