An Acute Confusional State
Izvo zvakanyanya kuora mwoyo, iyo inozivikanwawo sekuti delirium kana encephalopathy, inowanzoonekwa muzvipatara izvo zvava kuda kuonekwa sechinhu chinowanzoitwa nevazhinji vepachipatara. Pakati pe14 kusvika ku5 muzana yevashandi vose vari muchipatara vanotanga kuvhiringidzika. Vagari vakagadziriswa muimba huru yekuchengetedza vane yepamusoro, uye vanosvika 82 kubva muzana.
Kunyange zvazvo delirium isingazivikanwi nevashandi vezvipatara, inonyanya kushamisa uye inoshungurudza shamwari neshamwari dzemhuri.
Mudiwa wavo, murwere, haangazvizivi. Mune zvimwe zviitiko, murwere anogona kutopomera hama kana shamwari dzezviito zvakanyanya kufanana nekuedza kumusunga kana kumuuraya. Zvinogona kuonekwa sokuti mumwe munhu asingatauri mupfungwa ane muviri wemurwere.
Dhiriamu inowanzotora nguva uye inovandudza sezvo murwere achiporesa kurwara kwavo. Zvisinei, izvozvo hazvirevi kuti delirium inobata. Dhiriamu inobatanidza nepamusoro pekuwedzera kwemaviri-mwedzi gumi-gumi, kunyange mushure mekugadzirisa zvirwere zvakasimba. Inobatanidzawo nekugara kwenguva refu kuchipatara uye huwandu huwandu hwekudzivirira chirwere chemangwana .
Zviratidzo zveDhirisamu
Varwere vanotambura kubva kuna delirium vangave vasingazivi kwavari ivo kana kutoziva kuti gore ripi. Vanogona kukanganisa maitiro evanhu vanowanzozivikanwa vanouya kuzovashanyira. Hluccinations zvakajairika zvakare. Chimwe chezviyeuchidzo zvakasimba zvehutano hwakaoma huri kuoma kunetseka kune chimwe chinhu kwenguva yakareba.
Dzimwe nguva diriamu inogona kukonzera mumwe munhu kuti atange kushungurudzika, kana zviitiko izvo vangave vachidanidzira kana kuti vachinetseka kuti vabude pamubhedha. Vakadaro vakagumbuka varwere vanogonawo kuedza kubvisa mabhesi kana IV migero iri kupa mishonga inoponesa upenyu. Nenzira yakanaka, inenge 10 muzana yevarwere vanoponesa ndeiyi inonzi "hyperactive" subtype.
Kazhinji nguva, delirium haisi pachena uye varwere vanogona kungovata vachirara pamubhedha, asi pasina pfungwa chaiyo yezvinoitika kune avo. Vanhu ava vanogona kunge vari kurema kana kuti vasingateereri. Izvi zvinozivikanwa se "hypoactive" delirium, uye inenge makumi mana kubva muzana yevarwere vanoyevedza vachave nemhando iyi. Vakasara makumi mashanu kubva muzana yevarwere vane delirium "vakavhenganiswa," pamwe chete vachitambura nehupenzi uye zviratidzo zvehupenzi.
Kusiyana kwepfungwa mukuoma kwakakosha kwechirevo. Maminitsi mumwe murwere angaita seanoita ivo pachavo, uye neminiti inotevera angaita seumwe munhu zvachose. Izvi zvinogona kupedzisira zvichingoitika maawa. Dhiriamu inowanzowedzera panguva iyo murwere angawanzoenda kunorara, chimwe chinhu chinozivikanwa muzvipatara se "sundowning."
Zvinokonzera Deliriamu
Nzira yemazuva ano yekufunga pamusoro pemuramiro ndeyekuti munhu angave ane mungozi yezvikonzero zvekuvhiringidzika, izvo mune mamwe mamiriro ezvinhu zvinogona kupedzisira zvazara. Semuenzaniso, murwere akwegura angave ane hutano husina kunyatsoziva , asi ezvo unovandudza urwere hwehutachiona hwehutano hunoita kuti uwedzere kuora mwoyo . Doro rinoshandisa, kuora mwoyo, kusadya zvokudya zvakakwana, mamwe mishonga, uye kuora mwoyo kwemaonero uye kunzwa kunogonawo kugadzirisa mumwe munhu kumuranda.
Pane rurefu rurefu rwezvinhu zvinogona kukonzera mumwe munhu ane dambudziko rekunyanyisa kunetseka kuti ave pachena. Zvingava zvinobatsira kuvimba pamwonic "delirium" kuti uyeuke zvimwe zvezvikonzero zvinokonzera:
D - Zvinodhaka: Ichi ndicho chikonzero chinonyanya kukonzera chidimbu. Kuwedzera mishonga mitatu mishonga muchipatara kugara kunowedzera dambudziko rekuripira katatu muvatana vakwegura. Vaya vanowanzovhiringidza mishonga inonzi anticholinergic yakawanda seyaishandiswa kurapa urinary incontinence. Benzodiazepines uye opiates inowanzova nemhosva. Zvisinei, urongwa hwemimwe mishonga inogona kukonzera delirium inosanganisira antihistamines , antiepileptics , steroids, mamwe maantibayoti, nevamwe vakawanda.
E - Epilepsy: Apo kugumburwa kwave kuchiitwa sechikonzero chisingaiti chikonzero chekuchinja kwepfungwa, zvidzidzo zvezvino zvaratidza kuti huwandu hwevarwere, kunyanya kuI ICUs, huri kutambura nehuwandu husina kuputika epilepticus , zvinoreva kuti vanowanzotora nguva dzose kunze kwekunyatsokonzera kushamwaridzana kwesimba.
L - Makomba: Mhepo duku yakanyanya kana kuti carbon dioxide yakawanda nekuda kwekuoma kufema kunogona kuita kuti pave nekunyanyisa kukuru. Kuvhiringidza kurara kwepabonde ndechimwe chinhu chinokonzera ngozi.
Ini-Kutapukisa: Zvichienderana nezvakaitika kune mumwe munhu ndeyekuvhiringidzika kwakanyanya, chero chero hutachiona hupi hungavamanikidza kusvika pamucheto kuenda ku delirium, kusanganisira zvirwere zvishoma zvehutachiwana. Zvimwe zvinowanzoitika, chirwere chinokonzera urinary, pneumonia, kana chirwere cheganda ndicho chikonzero.
R - Kuchengetwa: Izvi zvinogona kureva kuchengetedza kwemuti kana uranda. Kuvhara muviri kunowanzopa mukana wekupedza.
Ini-Kuputika: Ichi chikamu chinopararira muchizvivako sezvo zvinhu zvakawanda mumuviri zvinogona kuita mhinduro yekuputira. Allergic response is one possible. Kuvhiya chinhu chinowanzopa chikamu chekurima. Zvisizvo zvinokonzerwa nemakumbo zvinogona kuita izvi zvakare.
U - Kusagadzikana: Zvinonyanya kuora mwoyo zvinogona kushanda sechiratidzo chekuyeuchidza kuti murwere ari kurwara zvikuru. Ropa rinomanikidzana kana rakanyanya kukwirira rinogona kukonzera kuora mwoyo, sezvinogona myocardial infarction (kurwisa kwemoyo). Kurohwa kashoma kunokonzera delirium pasina chimwe chiratidzo chekurohwa , sekushaya simba kwemaoko kana gumbo, asi kazhinji kacho kungangokonzera kukanganiswa.
M - Metabolic: Izvi zvinosanganisira zvinetso zvehutachiona pamwe nechirwere cheshuga, izvo zvinogona kutungamirira kuhuga hwehuga huri pasi ( hypoglycemia ) kana kuti yakakwirira (hyperglycemia). Mamwe mahomoni akaita sa cortisol anogonawo kutungamirira kuchinje pakufunga. Kusagadzikana kwezvokudya zvinovaka muviri uye kukundikana kwechirwere kunogona kuiswawo mune izvi.
Sezvaunogona kuona, kune chikonzero chikuru chezvikonzero zvekuti murwere asanganiswe muchipatara. Vakawanda vanovhiringidzwa nevarwere vane zvinopfuura imwechete njodzi inokonzerwa ne delirium. Izvo zvinyorwa zviri pamusoro apa hazvirevi zvimwe zvinowanzoitika zvekurima zvakadai sokurara kwekurara, catheterizations, uye nzira dzakawanda dzinowanikwa mune zvipatara. Dzimwe nguva vanachiremba vanofanirwa kufamba famba yakanaka mumutungamiri we delirium. Semuenzaniso, apo marwadzo anogona kukonzera delirium, saka zvinogona kuwedzera kurwadziwa kwemishonga. Kunyange zvazvo kuzvidzora kwepanyama dzimwe nguva kunoda kumisa musikana akavhiringidzika kubva pakudhonza mitsara uye mabheji, kuzvidzora kwepanyama kunowedzera kuwedzera kuvhiringidzika.
Nenzira, kune mamwe matanho ayo vashandi vezvechiremba uye vemhuri vanogona kutora kuti vabatsire kuchengetedza remrium kubva pakubuda kunze apo zvinetso zviri pasi zviri kururamiswa. Dheriamu inotyisa, asi inenge isina kumbogara yakasimba. Kuchengetedzwa kwakakodzera kwomurwere kunogona kubatsira kuve nechokwadi chokuti munhu wose anowana ruzivo rwekusava nematambudziko zvishoma sezvinobvira.
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