Delirium (Gmo 3a)
3
DELIRIUM Delirium didefinisikan sebagai gangguan kognitif dan kesadaran fluktuatif yang terjadi secara akut. Delirium merupakan sindrom bukan penyakit. Epidemiologi : 0,4% terjadi pada usia ≥18 taun dan 1,1% usia ≥!!taun. 10"#0% pasien yang dira$at diruma sakit mengalami delirium. #0% pasien di surgical intensie care unit dan cardiac intensie care unit mengalami delirium. 40% pasien post op fraktur panggul mengalami delirium. Etiologi : &'( diso rder : (ei)ure *postictal, nonconu lsie sta tus, sta tus+ igraine -rauma kepala, -umor o tak, (/, subdural,epidural ematoma, abscess, &/, &erebellar emorrage, nonemorragic stroke, transient iscemia etabolic disor de r : gang gu an elektr olit Diabetes, ipoglikemi, iperglikemi, resistensi insulin (ystemic illness : nfeksi *sepsis, malaria, e ry sipelas, iral, plague, l yme disease, sypilis, abscess+ -rauma erubaan cairan *deidrasi, olume oerload+ Defisiensi nutrisi 2uka bakar 3ncontrolled pain /eat stroke /ig altitude * !000m+ edica tio n : ain medica tio n * posto pe rati e meperidine, mo rp ine + ntibiotic, antiiral, anti fungal (teroid nestesia &ardiac medication ntiipertensi ntineoplastic agent nticolinergic agentome 'euroleptic malignant syndrome (erotonin syndrome 5er te counter preparation * erbal, te, suplemen+ 6otanical *7 imson$eed, oleander+ &ardia c *cardi ac f ailure, ar itmia, myo card i nf arct, cardiac assist de ice, car di ac sur ge ry+ ulmonary * &5D, ypoia, (D/, acid base disorder+ 9ndocrine * k risis adrenal, abnormalitas ty roid ata u p ara ty roi d+ enal *renal failure, uremia+ /epar *epatitis, cirrosis, epatic failure+ 'eoplasma
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Delirium due to mental organic disorder
Transcript of Delirium (Gmo 3a)
7/21/2019 Delirium (Gmo 3a)
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Kriteria diagnosis delirium
. -ere is clouding of consciousness, i.e., reduced clarity of a$areness of teenironment, $it reduced ability to focus, sustain, or sift attention.
6. Disturbance of cognition is manifest by bot:
1. impairment of immediate recall and recent memory, $it relatiely intact remotememory;
<. disorientation in time, place, or person.
&. t least one of te follo$ing psycomotor disturbances is present:
1. rapid, unpredictable sifts from ypoactiity to yperactiity;
<. increased reaction time;
#. increased or decreased flo$ of speec;
4. enanced startle reaction.
D. -ere is disturbance of sleep or of te sleep"$ake cycle, manifest by at least one of tefollo$ing:
1. insomnia, $ic in seere cases may inole total sleep loss, $it or $itoutdaytime dro$siness, or reersal of te sleep"$ake cycle;
<. nocturnal $orsening of symptoms;
#. disturbing dreams and nigtmares, $ic may continue as allucinations orillusions after a$akening.
9. (ymptoms ae rapid onset and so$ fluctuations oer te course of te day.
=. -ere is objectie eidence from istory, pysical and neurological eamination, orlaboratory tests of an underlying cerebral or systemic disease *oter tan psycoactiesubstance"related+ tat can be presumed to be responsible for te clinical manifestationsin &riteria " D.
Pemeriksaan Tambahan
emeriksaan standar 6lood cemistries *electrolytes, renal and epatic indees, and glucose+ &omplete blood count $it $ite cell differential -yroid function tests (erologic tests for sypilis /uman immunodeficiency irus */>+ antibody test 3rinalysis
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