Conclusion
Recognition of predisposing factors is essential for identifying elderly patient at risk for developing delirium. This will help target both treatment and prevention strategies with the goal of reducing the severity or preventing the occurrence of delirium .
Before admission, perioperative status and risk of developing delirium and establish a baseline using tools such as Mini-Cog Test,GDS, and CAM. Intraoperatively,nurses should monitor the patient’s vital signs (eg. Blood pressure,oxygen saturation); correct electrolyte imbalances, particularly disorders of sodium and potassium; and maintain reasonable blood sugar control and volume status.
During the postoperative period, perioperative nurses should provide environment and personal orientation,reduce medication while maintaining adequate pain control, and ensure hearing aids and eyeglasses are available and good working order. Nurses should involve relatives and caregivers as soon as possible and encourage the caregivers as soon as possible and encourage the patient to ambulate early.If at all possible, nurses should avoid placing a urinary catheter, but if necessary,the catheter should be removed as soon as possible. Nurses should make every effort to limit environmental noise and disruptions and avoid administering meperidine , benzodiazepines, and anticholinergic agents if at all possible.
Developing skills in recognizing patient who are at high risk for delirium will help target both treatment and prevention strategies. Perioperative nurses can play a major role in helping to reduce the risk of delirium through careful monitoring and planning.