RESUMO
This article discusses the management of acute confusion and aggression in patients with infections of the central nervous system (CNS). The issues discussed are applicable to the management of acute confusion of any cause and the principles of care apply to all confused patients. The article addresses many of the challenges encountered by nurses caring for confused patients, including the recognition of acute confusion, use of screening tools, and the management and treatment of these patients.
Assuntos
Agressão , Infecções do Sistema Nervoso Central/diagnóstico , Infecções do Sistema Nervoso Central/enfermagem , Confusão/enfermagem , Delírio/enfermagem , Recursos Humanos de Enfermagem Hospitalar/educação , Doença Aguda/enfermagem , Adulto , Infecções do Sistema Nervoso Central/complicações , Confusão/etiologia , Currículo , Delírio/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Fatores de Risco , Reino UnidoRESUMO
Lumbar puncture has an important role in the diagnosis of acute central nervous system infections. The clinical contraindications to lumbar puncture must be considered before the procedure is carried out, and nurses need to have an understanding of how best to inform, support and reassure patients.
Assuntos
Infecções do Sistema Nervoso Central/diagnóstico , Educação Continuada em Enfermagem , Punção Espinal , Doença Aguda , Infecções do Sistema Nervoso Central/enfermagem , Humanos , Consentimento Livre e Esclarecido , Reino UnidoRESUMO
OBJECTIVE: As their differential needs are unknown and to inform service planning, this study (a) examined experiences of caring for adults with acquired brain injury (ABI) and (b) compared these with carers of adults with dementia. DESIGN: Cross-sectional postal survey. ABI carer experiences were compared with those of a previously studied group of dementia carers using equivalent instruments. METHODS: Family carers (n = 222) of adults with ABI: TBI (49%), strokes (26%), brain infections (18%) and other (7%) completed validated questionnaires assessing physical dependency and psychological problems of those cared for and carers' own perceived burden, quality-of-life and mental health. RESULTS: Carer burden, quality-of-life and mental health were worse for ABI carers, but were not predicted by gender, relationship, injury type, physical dependency or cognitive problems in either ABI or dementia carers. Behavioural problems of those cared for varied between the two groups and affected carers differently. Aggressive problems significantly predicted greater burden, poor quality-of-life and mental health in ABI carers, whereas passivity/low mood significantly predicted greater burden and worse quality-of-life in dementia carers. CONCLUSIONS: This study revealed different experiences of caring for younger adults with ABI vs. older adults with dementia, thereby supporting targeted development of services to sustain families affected by these conditions.
