Domain 5. Perception-cognition
Class 4. Cognition
Diagnostic Code: 00129
Nanda label: Chronic confusion
Diagnostic focus: Confusion
Nursing diagnosis chronic confusion includes the assessment of an individual’s mental health that may be influenced by a variety of factors. It is important to recognize and appropriately address any underlying conditions that may be causing the confusion. This type of nursing diagnosis is commonly seen as a symptom of a variety of neurological, cognitive or mental health disorders, including but not limited to dementia, Alzheimer’s disease, stroke, and substance abuse.
NANDA Nursing Diagnosis Definition
NANDA nursing diagnosis, or the North American Nursing Diagnosis Association, defines nursing diagnoses as “a clinical judgment regarding the potential stresses experiencing by individuals, families, or communities, in order to help guide further evaluation and treatment.” According to NANDA, nursing diagnosis chronic confusion is defined as “acute or chronic confusion resulting from an altered mental status in which the ability to think, reason, and remember are disturbed.”
The defining characteristics of nursing diagnosis chronic confusion refers to subjective and objective findings. Subjective findings include complaints of confusion, disorientation, difficulty communicating, decreased attention span, and difficulty initiating tasks and activities. Objective findings may present as disorganized thinking, malnutrition, insomnia, memory deficits, poor hygiene, or poor judgment.
There are numerous factors that can contribute to nursing diagnosis chronic confusion, ranging from lifestyle factors and medications to underlying pathologies such as dementia or stroke. Some of the most common related factors include multi-systems diseases, infection, hypoxia, head trauma, alcoholism, dementia, cardiovascular disease, neurological impairment, and endocrine disorders such as diabetes or Cushing’s syndrome.
At Risk Population
Nursing diagnosis chronic confusion can affect people of all ages, primarily those in the elderly population, due to underlying medical conditions or lifestyle factors. Other at-risk populations may include those with chronic medical conditions such as kidney failure, liver disease, or HIV/AIDS, as well as those who have recently had surgery, suffered from a head injury, or have been exposed to toxins.
There are also several associated conditions that can cause nursing diagnosis chronic confusion, including anxiety, depression, delirium, schizophrenia, organic mental health disorder, or personality disorder. Additionally, there may be certain medications that can cause changes in mental status and confusion, including anti-seizure medications, steroids, chemotherapy drugs, opioids, or anticholinergic medications.
Suggestions for Use
When diagnosing nursing diagnosis chronic confusion, it is important to assess the current presenting symptoms, conduct a thorough physical examination and review the patient’s medical history and medications. Additionally, it is important to consider any environmental factors that may be contributing to the confusion. Neuropsychological and laboratory testing should also be conducted to measure physiological changes.
Suggested Alternative NANDA Nursing Diagnoses
In some cases, patients may present with alternative or combined diagnoses. Common alternative diagnoses to nursing diagnosis chronic confusion include acute confusion, delirium, cognitive deficit, disturbance in thought processes, and impaired social interaction. It is important to recognize and appropriately address these alternative diagnoses based on the patient’s presentation.
When addressing nursing diagnosis chronic confusion, it is important to promote a positive environment and emotional support. It is also essential to assess the extent of change in cognition, behavior, emotional state, language comprehension/expression, and memory. Additionally, as many patients with chronic confusion may be prescribed multiple medications, dosage management is crucial.
Patients with nursing diagnosis chronic confusion should be monitored in accordance with the outcomes outlined by NOC. These outcomes include: Orientation Performance, Memory Performance, Sustained Attention, Communication Status, Capability for Social Interaction, Problem Solving and Decision Making, Safety Awareness, Self-Care Management, Mood Equilibrium, Coping, and Stress Tolerance.
Evaluation Objectives and Criteria
When evaluating nursing diagnosis chronic confusion, it is important to measure the patient’s responses through observation, interviews, and tests. During this process, it is crucial to look for improvements in orientation, memory, attention, communication, social functioning, problem solving, safety awareness, self-care management, mood equilibrium, coping, and stress tolerance.
Interventions for nursing diagnosis chronic confusion should focus on providing patient education about the medical condition, promoting safety, decreasing environmental stimuli, providing emotional support, and improving quality of life. Specific interventions may include Cognitive Stimulation Therapy, Activity Therapy, Person-Centered Care, Family Education, Environmental Management, Music Therapy, Leisure Activities, Culture Change, and Assistance with Life Activities.
Nursing activities related to nursing diagnosis chronic confusion may involve monitoring vitals, providing emotional support, administering medications and treatments, monitoring nutrition, observing the patient’s behavior, assisting with personal cares, assessing risk of harm to self or others, reporting changes in status, and developing action plans.
Nursing diagnosis chronic confusion is a complex diagnosis that requires a comprehensive assessment in order to develop an effective evidence-based treatment plan. It is important to recognize and appropriately address any underlying causes of the confusion in order to minimize the risk of further decline in health status. With appropriate assessment, intervention, and follow up, patients can experience improved mental health and quality of life.
- Q1: What is nursing diagnosis chronic confusion?
A1: Nursing diagnosis chronic confusion refers to acute or chronic confusion resulting from an altered mental state in which the ability to think, reason and remember are disturbed.
- Q2: What are the commonly seen causes of nursing diagnosis chronic confusion?
A2: Commonly seen causes of nursing diagnosis chronic confusion include multi-systems diseases, infections, hypoxia, head trauma, substance abuse, dementia, stroke, cardiovascular disease, and endocrine disorders.
- Q3: What are the subjective and objective findings associated with nursing diagnosis chronic confusion?
A3: The subjective findings associated with nursing diagnosis chronic confusion include complaints of confusion, disorientation, difficulty communicating, decreased attention span, and difficulty initiating tasks and activities. Objective findings may present as disorganized thinking, malnutrition, insomnia, memory deficits, poor hygiene, or poor judgement.
- Q4: What nursing interventions are used to address nursing diagnosis chronic confusion?
A4: Nursing interventions for nursing diagnosis chronic confusion may involve patient education about the medical condition, promoting safety, decreasing environmental stimuli, providing emotional support, cognitive stimulation therapy, activity therapy, person-centered care, family education, environmental management, music therapy and leisure activities.
- Q5: What are some of the outcomes that should be monitored when addressing nursing diagnosis chronic confusion?
A5: The outcomes that should be monitored when addressing nursing diagnosis chronic confusion include orientation performance, memory performance, sustained attention, communication status, capability for social interaction, problem solving and decision making, safety awareness, self-care management, mood equilibrium, coping and stress tolerance.