The following are the most important diseases or complications that may be contributed to by delirium: Psyche – Nervous System (F00-F99; G00-G99). Recurrent delirium (recurrent delirium). Cognitive deficits Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99). Propensity to fall Further Social restrictions Nursing home admission (seniors; because of postoperative cognitive deficit (POCD) … Delirium: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin, mucous membranes, and sclerae (white part of the eye) [symptoms of delirium tremens (alcohol withdrawal delirium): sweating, tremor (shaking; assessing fluid balance (e.g., signs of desiccosis (dehydration)) Auscultation … Delirium: Examination
1st order laboratory parameters – obligatory laboratory tests. Small blood count [MCV ↑ in alcohol abuse and myxedema] Differential blood count Inflammatory parameter – CRP (C-reactive protein) Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, ketone, urobilinogen, bilirubin, blood), sediment, if necessary urine culture (pathogen detection and resistogram, that is, testing suitable antibiotics … Delirium: Test and Diagnosis
Therapy goals Relief of symptoms As far as available: Balancing the electrolyte and water balance. Correction of a metabolic disorder Treatment of an infection Prevention of social restrictions Therapy recommendations Inpatient monitoring (a potentially life-threatening condition is present). Symptom-oriented and prompt therapy Analgesics (painkillers) and sedatives (tranquilizers) should not be abruptly discontinued, but phased out. … Delirium: Drug Therapy
Obligatory medical device diagnostics. Electrocardiogram (ECG; recording of the electrical activity of the heart muscle). Abdominal sonography (ultrasound examination of the abdominal organs) – for basic diagnostics. X-ray of the thorax (X-ray thorax/chest), in two planes [may indicate hypoxia: e.g., evidence of heart failure/heart failure, pneumonia/pneumonia]. Optional medical device diagnostics – depending on the results … Delirium: Diagnostic Tests
To prevent delirium, attention must be paid to reducing individual risk factors. Reinforce delirium risk: Behavioral risk factors Diet Malnutrition Consumption of stimulants Alcohol (here: alcohol abuse) Drug use Amphetamines and metamphetamines (“crystal meth”). Ecstasy (also XTC and others) – collective name for a variety of phenylethylamines. GHB (4-hydroxybutanoic acid, obsolete also gamma-hydroxybutanoic acid or … Delirium: Prevention
The following symptoms and complaints may indicate delirium: Leading symptoms Cognitive disturbance (memory impairment) with impaired perception (disorientation), fluctuating over hours/days Attention deficit Restriction of perception, speech, etc. to varying degrees. Altered sleep-wake rhythm, ie reversal of the day-night rhythm. (Optical) hallucinations, delusions. Affective disorders Signs of hypoactive delirium Withdrawn into himself Apathy (apathy) Psychomotor … Delirium: Symptoms, Complaints, Signs
The following are the most important diseases or complications that may be contributed to by tobacco dependence: Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Maldescensus testis (undescended testis). Respiratory system (J00-J99) Acute bronchitis Bronchial asthma Chronic bronchitis Chronic obstructive pulmonary disease (COPD) Interstitial lung disease (differential diagnosis to be considered in smokers with exertional dyspnea … Tobacco Dependence: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Of the skin, mucous membranes, pharynx (throat) and sclerae (white part of the eye) [due topossible sequelae: pharyngitis (pharyngitis), tonsillitis (tonsillitis)]. Extremities [cold, in nicotine intoxication: muscle tremors]. Auscultation … Tobacco Dependence: Examination
Determination of laboratory parameters are generally not indicated for mental and behavioral disorders associated with tobacco dependence. Diseases – see self-history – that can be or are the consequence of atherosclerosis (arteriosclerosis, hardening of the arteries) – as a consequence of tobacco dependence – require diagnostic clarification according to the guidelines of Evidence Based Medicine. … Tobacco Dependence: Test and Diagnosis
Therapy goal Alleviation of withdrawal symptoms. Therapy recommendations Note any symptoms of tobacco withdrawal syndrome that may occur: First withdrawal symptoms after 1-2 h. Increase in symptoms in the first 6-12 h. Maximum of complaints after 1-3 days Persistence of complaints up to 3 weeks Typical withdrawal symptoms include craving (violent desire for tobacco), dysphoric … Tobacco Dependence: Drug Therapy
Medical device diagnostics are generally not indicated for mental and behavioral disorders related to tobacco dependence. Diseases – see self-history – that can be or are a consequence of atherosclerosis (arteriosclerosis, hardening of the arteries) – as a consequence of tobacco dependence – require diagnostic clarification according to the guidelines of Evidence Based Medicine. Optional … Tobacco Dependence: Diagnostic Tests
