Acute confusion

Acute confusion

Domain 5. Perception-cognition
Class 4. Cognition
Diagnostic Code: 00128
Nanda label: Acute confusion
Diagnostic focus: Confusion

Nursing diagnosis is “the label given to a specific patient health or illness problem” (1). Acute confusion is an acute state of physical and mental deterioration and disorientation caused by such things as infection, drug toxicity, disease, etc. It has different symptoms that can occur simultaneously, making it difficult for nurses to accurately identify exactly what the diagnosis is. This article will discuss the NANDA nursing diagnosis definition, associated factors, at-risk populations, defining characteristics, suggested alternative NANDA nursing diagnoses, usage tips, NOC outcomes, NIC interventions, nursing activities, evaluation objectives and criteria, and a conclusion. Additionally, a set of Frequently Asked Questions (FAQs) about nursing diagnosis acute confusion in a script format will provide guidance and answers to any further questions you may have.

NANDA Nursing Diagnosis Definition

The NANDA International (NANDA-I) nursing diagnosis “acute confusion” is defined as a state in which focus and thinking are impaired due to a variety of etiologies (2). The vital signs of this diagnosis include a diminished level of consciousness, disorientation, disordered thinking, and disturbed communication (3). In the event, one cannot distinguish between reality and fantasy, and fails to understand spoken words, these are all symptoms of acute confusion.

Defining Characteristics

Subjective Symptoms

  • Restlessness
  • Flat emotional response
  • Excessive agitation
  • Incoherent ramblings
  • Periods of lucidity followed by periods of confusion

Objective Signs

  • Inability to follow simple instructions
  • Unequal pupil size
  • Decreased level of organization of thought processes
  • Inappropriate motor responses
  • Hallucinations

Related Factors

The etiologies of acute confusion are numerous and include medical conditions, medications, electrolyte and acid-base disturbances, environmental factors, and psychological conditions (4). Medical conditions such as stroke, trauma, or brain tumors can cause confusion and disorientation. Similarly, certain drugs, especially psychotropic drugs, can lead to confusion and disorientation when taken in excess or in the wrong combination. Electrolyte imbalances and acid-base imbalance can cause confusion and disorientation. Finally, psychological conditions such as dementia, delirium, or depression can trigger confusion.

At Risk Population

Individuals at risk of developing acute confusion include patients with a pre-existing neurological disorder, elderly people, those who take multiple medications, those who abuse alcohol or drugs, and individuals in high-stress environments (5). Patients with a pre-existing neurological disorder such as stroke, traumatic brain injury, or dementia are at greater risk of becoming confused because their brain may not function optimally. Elderly people are more prone to becoming confused because as we age, our brain’s ability to process information deteriorates. Individuals who take multiple medications, as well as those who abuse alcohol or drugs, are also at increased risk of becoming confused. Finally, individuals in particularly stressful environments are more likely to experience confusion.

Associated Conditions

There are a number of conditions that are often associated with acute confusion. These include headaches, seizures, fatigue, inability to concentrate, personality changes, forgetfulness, hallucinations, delusions, hyperactivity, irritability, anxiety, restlessness, impaired judgement, and memory problems (6). These various symptoms can occur both alone or concurrently, so it is important to be aware of them in order to effectively diagnose and treat patients who are exhibiting confusion.

Suggestions of Use

The primary goal of nursing diagnosis acute confusion is to identify the underlying cause and develop a treatment plan that will reduce the severity of symptoms and help prevent further deterioration. Furthermore, it can also provide insight into potential risks and how to best manage those risks. Intellectual stimulation and environmental modification can be used to reduce confusion and support cognitive functioning. It is also important to involve family members to ensure proper compliance with the prescribed intervention.

Suggested Alternative NANDA Nursing Diagnoses

In the event, acute confusion is suspected but not confirmed, it is recommended that alternative NANDA diagnoses be considered. These diagnoses include impaired cognition, disorganized thinking, altered thought processes, impaired social interaction, risk for disorientation, and risk for impaired perception (7). Differentiating between these diagnoses will help identify which treatments are most appropriate for the individual patient.

Usage Tips

When using nursing diagnosis acute confusion, it is important to note the individual patient’s circumstances, including medical or psychological history, current medications, and lifestyle. Additionally, ask family and friends familiar with the patient to assess the individual’s cognitive functioning, conduct a physical exam, and ask questions to determine potential areas of confusion.

NOC Outcomes

NOC outcomes for nursing diagnosis acute confusion include decrease confusion, increase safety awareness, desire to interact socially, ability to learn, ability to follow verbal and written instructions, changes in behavior and insight, and improved orientation (8). These outcomes should be tracked over time to measure and document the patient’s progress.

NIC Interventions

Interventions for nursing diagnosis acute confusion typically fall under five categories. Reorientation, distraction and calming techniques, environment management, physical conditioning and hygiene, and health maintenance (9). Reorientations involve orienting the patient to time, place, and person while distracting and calming techniques can range from music or gentle conversation to guided imagery or massage. Environment management involves providing a physically and emotionally secure environment, while physical conditioning and hygiene encompasses basic needs such as eating, sleeping, and grooming. Finally, health-maintenance focuses on the physical and emotional wellbeing of the patient, by maintaining vital signs and managing pain.

Nursing Activities

When caring for a patient exhibiting acute confusion, it is essential to perform a focused and dynamic assessment to differentiate the cause of confusion. Emotional involvement and interaction with the patient are key components of this process. Additionally, nurses should provide reassurance and support to the patient, provide safety precautions as necessary, and collaborate with the interdisciplinary team to coordinate the plan of care.

Conclusion

In conclusion, nursing diagnosis acute confusion is an acute state of physical and mental deterioration and disorientation caused by various etiologies. It is essential to accurately identify and diagnose the condition, as well as develop a treatment plan to reduce the severity of symptoms and improve the patient’s quality of life. Nursing diagnosis acute confusion requires a comprehensive approach, including proper use of diagnostic criteria, identification of related factors and at-risk populations, and a set of NOC and NIC interventions.

Frequently Asked Questions

  • Q: What are the symptoms of nursing diagnosis acute confusion?
    A: The symptoms of nursing diagnosis acute confusion include restlessness, flat emotional response, incoherent ramblings, inability to follow simple instructions, unequal pupil size, decreased level of organization of thought processes, hallucinations, and other related signs and symptoms.
  • Q: Who is at risk of developing nursing diagnosis acute confusion?
    A: Individuals at risk of developing nursing diagnosis acute confusion include patients with a pre-existing neurological disorder, elderly people, those who take multiple medications, those who abuse alcohol or drugs, and individuals in high-stress environments.
  • Q: What are some related conditions associated with nursing diagnosis acute confusion?
    A: The related conditions associated with nursing diagnosis acute confusion include headaches, seizures, fatigue, inability to concentrate, personality changes, forgetfulness, hallucinations, delusions, hyperactivity, irritability, anxiety, restlessness, impaired judgement, and memory problems.
  • Q: What is the primary goal of nursing diagnosis acute confusion?
    A: The primary goal of nursing diagnosis acute confusion is to identify the underlying cause and develop a treatment plan that will reduce the severity of symptoms and help prevent further deterioration.
  • Q: What are the NOC outcomes for nursing diagnosis acute confusion?
    A: The NOC outcomes for nursing diagnosis acute confusion include decrease confusion, increase safety awareness, desire to interact socially, ability to learn, ability to follow verbal and written instructions, changes in behavior and insight, and improved orientation.