Delirium Management After Urological Surgery

Yıl 2024, Cilt: 5 Sayı: 3, 717 - 729, 07.12.2024

Büşra Dişbudak , Ezgi Seyhan Ak

https://doi.org/10.58605/bingolsaglik.1552822

Öz

Delirium after urologic surgery is a common complication, especially in elderly patients. It negatively affects the postoperative recovery process, prolongs hospitalization and increases health care costs. Advanced age, cognitive dysfunction, pain, infections, anemia, electrolyte and hormonal imbalances, renal failure, dehydration, major and prolonged surgical interventions are among the factors that increase the risk of developing delirium. Recent studies have revealed that the risk of delirium in patients undergoing urologic surgery is considerable, although not as much as major surgeries. Especially the need for prolonged catheterization after surgeries such as transurethral prostate resection or radical nephrectomy is one of the factors that increase the risk of delirium. Prevention and management of delirium is a multidisciplinary process. Non-pharmacologic methods are as effective as pharmacologic treatments and the role of nurses is of great importance. Interventions such as early mobilization, increasing sensory stimuli, cognitive activities, ensuring adequate fluid and nutrient intake are accepted as effective strategies to prevent delirium. When delirium develops, it should be managed by a multidisciplinary team and evidence-based treatment protocols should be rapidly implemented. In this article, we review the risk factors, preventive interventions, and management of delirium after urologic surgery.

Anahtar Kelimeler

Urologoical surgery, postoperative care, delirium, nursing

Proje Numarası

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Ürolojik Cerrahi Sonrası Deliryum Yönetimi

Öz

Ürolojik cerrahi sonrası deliryum, özellikle yaşlı hastalarda sık karşılaşılan önemli bir komplikasyon olup, postoperatif iyileşme sürecini olumsuz yönde etkileyerek, hastanede kalış süresini uzatmakta ve sağlık bakım maliyetlerini artırmaktadır. İleri yaş, bilişsel fonksiyon bozuklukları, ağrı, enfeksiyonlar, anemi, elektrolit ve hormonal dengesizlikler, böbrek yetmezliği, dehidratasyon, majör ve uzun süreli cerrahi girişimler deliryum gelişim riskini artıran faktörler arasında yer almaktadır. Son yıllarda yapılan araştırmalar, ürolojik cerrahi geçiren hastalarda deliryum riskinin majör cerrahiler kadar olmasa da dikkate değer olduğunu ortaya koymuştur. Özellikle transüretral prostat rezeksiyonu veya radikal nefrektomi gibi cerrahilerin sonrasında uzun süreli kateterizasyon gereksinimi, deliryum riskini artıran faktörlerdendir. Deliryumun önlenmesi ve yönetimi, multidisipliner olarak ele alınması gereken bir süreçtir. Farmakolojik olmayan yöntemler, farmakolojik tedaviler kadar etkilidir ve hemşirelerin rolü büyük önem taşımaktadır. Erken mobilizasyon, duyusal uyaranların artırılması, bilişsel aktiviteler, yeterli sıvı ve besin alımının sağlanması gibi müdahaleler, deliryumu önlemede etkili stratejiler olarak kabul edilmektedir. Deliryum geliştiğinde ise, multidisipliner bir ekip tarafından yönetilmeli ve kanıta dayalı tedavi protokolleri hızla uygulanmalıdır. Bu makale, ürolojik cerrahi sonrası deliryum gelişiminde rol oynayan risk faktörlerini, önleyici girişimleri ve deliryumun gelişmesi durumunda uygulanabilecek farmakolojik ve non-farmakolojik tedavi yaklaşımlarını incelemektedir.

Anahtar Kelimeler

Ürolojik cerrahi, ameliyat sonrası bakım, deliryum, hemşirelik

Destekleyen Kurum

Yoktur.

Proje Numarası

-

Teşekkür

-

Kaynakça

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