Delirium is a sudden, fluctuating, and usually reversible disturbance of mental function (Yuying Fan, 2012). Delirium has been identified in several hospital settings; however, occurs more frequently in an Intensive Care setting. Risk factors are not limited to a certain age, race, or gender. There are several long and short term adverse effects associated with Delirium, and may even leave the patient in a decreased mental state after discharge. It is important to use the proper assessment tools to identify delirium in patients. More so, it is imperative that the medical and nursing staff be aware of all risk factors, signs and symptoms, and interventions to minimize and properly treat delirium in the ICU setting.
Patients in the Intensive Care Unit are at a high risk to develop delirium. It is one of the most common conditions encountered by the staff in an Intensive Care Unit. Delirium can be hyperactive or hypo active according to the patients’ behavior. Disorientation, agitation, hallucinations, or delusions are characteristics that may be observed in the patient with hyperactive delirium. Apathy, quietly confused, withdrawal, lethargy, and even total lack of responsiveness are all symptoms of hypoactive delirium. Some or all of these symptoms may be present at any time.
While the cause of delirium is usually multifactorial, there are several risk factors can be identified. The risk factors can be divided into 2 categories: predisposing factors (host factors) and precipitating factors (Alexander, 2009). Predisposing factors are those that occur before an ICU admission, leaving them difficult to alter or correct. Examples of predisposing risk factors include: older age, history of hypertension, smoking, or alcoholism. Precipitating risk factors are acute in nature, and occur during the ICU admission. Examples of these are: severity of illness, metabolic disturbances, acute infection, hypoxemia, surgery, anemia, acidosis, and hypotension (Alexander, 2009).
There is research that suggest that acute and chronic pain could be contributing factors to the development of delirium. According to Robinson and Vollmer (2010), a study of 12 young adults, researchers delivered a painful stimulus and asked the subjects to perform cognitive tasks of word repetition and word generation. Results showed that the subjects had difficulty disengaging from pain to complete tasks. According to Vollmer (2010), a study was performed which examined the ability of 12 patients with severe pain to perform cognitive tests before and after pain treatment. The results showed that prior to pain treatment, they had a hard time keeping their attention on a certain task to be able to perform them. According to Vollmer (2010), a study was done with patients who experienced chronic pain which tested mental flexibility and found pain severity was associated with increased impairment. It is often immediately assumed that the medications such as...