Pediatri Yoğun Bakımlarda Deliryum Yönetiminde Hemşirenin Sorumlulukları ve Rolleri

Yıl 2021, Cilt: 4 Sayı: 1, 67 - 78, 24.04.2021

İlçim Ercan , Evrim Kızıler

https://doi.org/10.51536/tusbad.832764

Öz

Deliryum, bilinç durumunda dalgalanmaya neden olan akut başlangıçlı mental bir durumdur. Yoğun bakım ünitelerinde tedavi gören çocuk hastalarda, ortamın gürültülü ve sürekli aydınlık olması, tıbbi cihazların varlığı, sağlık ekibinin tekrarlayan müdahaleleri ve mekanik ventilasyon ihtiyacı gibi nedenlerle görülme sıklığı %80’e kadar çıkmaktadır. Çocuk hastalarda deliryum yüksek mortalite oranlarıyla ilişkili, sık görülen bir sağlık sorunu olmasına rağmen çocuk gelişim düzeylerindeki farklılıklar, bilgi eksikliği, yapılan çalışmaların azlığı ve rutin değerlendirmede aksamalar nedeniyle pediatrik deliryum vakaları sağlık ekibi üyeleri tarafından ya erken dönemde fark edilememekte ya da depresyon gibi farklı bir tanı ile karıştırılabilmektedir. Bu durumda tablo daha da ilerlemekte, çocukların oryantasyonu, düşünce süreçleri, uyku düzenleri bozulmakta, hastanede kalış süresi uzamakta ve hatta hasta kaybedilebilmektedir. Yoğun bakımda tedavi gören çocuk hastalarla tedavi ve bakım gereği sürekli temas ve iletişim halinde olan hemşireler, hastada oluşabilecek ufak bir değişikliğin bile fark edilmesi, pediatrik deliryumun erken dönemde tanılanması ve tedavisinin sağlanmasında kritik rol oynamaktadır. Bu derlemede hemşirelerin pediatri yoğun bakımlarda deliryum yönetimindeki sorumluluk ve rollerinin vurgulanması amaçlanmıştır.

Anahtar Kelimeler

Delliryum, Hemşirelik, Pediatrik Yoğun Bakım Ünitesi

Nursing Responsibilities and Roles in Delirium Management in Pediatric Intensive Care Unit

Öz

Delirium which causes fluctations in consciousness is an acute mental state. Pediatric patients who treated in intensive care units, the incidence increases up to %80 because of noisy environment, permanent bright environment, presence of medical devices, repetitive intervetions of healthcare team and need for mechanical ventilation. Although delirium is a common health problem associated with high mortality rates in pediatric patients, not be noticed by healthcare team in early period or is mixed up with a different diagnosis such as deppresion due to differences in developmental levels, lack of information, minority of studies and hitch of routine evaluation. In this case, the status progresses further, orientation, thouht processes and sleep cycle decay, the duration of hospital stay is prolonged and even the patient may be died. Nurses, who are in constant contact and communication with pediatric patients who are treated in intensive care accordingly treatment and care, play a critical role in recognizing even a small alteration that occur in patient, early diagnosis of pediatric delirium and providing treatment. In this review, it is aimed to emphasize the responsibilities and roles of nurses in delirium management in pediatric intensive care units.

Anahtar Kelimeler

Delirium, Nursing, Pediatric Intensive Care Unit

Kaynakça

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