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Nursing Tools and Strategies to Assess Cognition and Confusion

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This article is worth reviewing it due to the fact that, it contains pertinent information that entails the code of conduct in the nursing field. It gives an overview of various challenges faced and, how they can be mitigated.  The article describes cognitive impairment to occur when there is difficulty with thoughts arises. It  further elucidates that , cognitive impairment can involve the loss of higher reasoning, decreased intelligence, learning disabilities, mental functioning reductions, difficulties in concentration, and forgetfulness. This condition maybe manifested at birth or may take place at later stages of human life.  Earlier causes of this cognitive impairment involves prenatal drugs exposure, chromosome abnormalities, malnutrition, lead poisoning, hypoglycemia, hypothyroidism, lack of oxygen in the womb or either during or after birth, complication of prematurity, neonatal jaundice. This information is worth for practicing nurses, so as, they may have first hand information while dealing with such situations.

The cognitive impairment has social effect as stated by Benner and Wrubel (1989). They elaborate further by saying that persons with neurological sickness maintain damage to themselves in a way that people with no other sickness do. Personality change and its impact is evident in the event that patients become strangers to their families and friends. It is the function of the brain to define our individuality and uniqueness. The incorporation of sensory data with mood, skills, feelings and memories is vital when interacting with the surroundings and communicating with others is our chief objective.

Florence Nightingale (1860) stresses that for a nurse; it is of absolute importance to develop the tradition of observing one way or another and taking of notes. It is only until then that one can be said to be a nurse who understands the pro and cons of nursing. It is for this reason, therefore, that nurses dealing with patience experiencing neurological dysfunction where keen observation skills are essential so as to detect distinct and ever-changing troubles felt by the patients.

Methodology

Aird & Mclntosh (2004) have employed surveys in their study to succinct the evidence of their findings. This includes te mini-mental status examination (MMSE) that aid in giving cognitive abilities of those patients with psychiatric problems. Various terms are used to define the mental status of patients; confusion, disorientation and delirium. It is unclear in the states which aren’t evidently and, consistently defined and this leads to vagueness. Some common terms used to define delirium include intensive care unit (ICU) psychosis or ICU syndrome. Aird & Mclntosh (2004) uses the Simpson (1984) investigation on what doctors and nurses mean when they describe a patient as confused. The sample included 58 physicians, 69 registered nurses, 74 patients and 73 psychiatric nurses. He stated that the word confused, has many different definitions. It involves disorientation to the time and place, and state in which there is a disturbance of consciousness, he also concluded that there is a wide discrepancy in the understanding of the word confusion, to such an extent that its meaning is vague.

This article vividly elaborates the term confused encompasses an amorphous group of symptoms.  It further stresses the need to include behavioral and cognitive data. Individuals having stress should focus on assessment based on how confusion interferes with patient’s ability to function rather than on interference with nurses’ function.  Indeed this is an important aspect as it enables the nurses to maintain the safety and, the dignity of a compromised vulnerable patient.

This article achieves its objective in ensuring that, cognition involves perception, thinking, remembering and organizing information. It is however, not clear as to whether observes cognitive functioning includes several domain of intellectual ability including; abstract reasoning, language, mental tracking, memory, set shifting, attention and visual spatial ability. This functions calls for self awareness and surrounding and here, consciousness and cognition are taken to be the one. This understanding is customary seen as a component of consciousness and any change in understanding reflect an altered mindful condition. It is mostly described in terms of confusion or disorientation.

Moreover, Aird & Mclntosh (2004) suggest that, cognition is a process that helps the patient to understand and keep insttructions, solve problems and initiate tasks. In addition, Dementia is a long-time memory, non-reversible loss of short-term and long-term memory. Dementia displays structural variations in the cerebral cortex. Moreover, Aird & Mclntosh (2004) argue that dementia isn’t a disease particularly, but a decline in social behavior and logical operation. Vital to this outlook is progressive in nature of dementia and the impact that the process has on the person and their family. He makes some fascinating distinctions linking the two syndromes stating that the defining characteristics of delirium are disturbed attention abilities and disordered thinking, which are not evident in dementia.

Traditionally, cognitive impairment and ageing are considered as being related. Cognitive impairment should not be felt as a benign and unavoidable part of ageing, but as a condition that warrants on time and destructive action. The article attributes that, the cognitive impairment is a significant illness for the critically ill older patients and is connected with severe negative consequences. The quality of incoming data is crucial in determining perceptual quality. Cognitive functioning, therefore, requires unbroken cortical and sub cortical structures essential for the understanding and incorporation of information. Delirium is a clinical analysis based mainly on the patient’s conduct. Nursing organization, therefore, should focus on the protection of the patients, as delirious patients have an amplified threat of accidental self-harm, such as dislodging life-support and monitoring apparatus. Confused patients are 2-5 times more expected to die than non-confused patients, and they are more probable to become enduringly cognitive impaired and to necessitate institutionalization.

Conclusion

In conclusion, this article summarizes that, cognitive assessment does not necessarily refer to intelligence testing or neuropsychological assessment. Even though, there exists an important feature of cognitive assessment with the mental status. Cognitive evaluation precipitates subjective concern, which disposes people to ponder more with current behavior. Moreover, it has ardently clarified the differences in confusion and cognition that exists in the nursing field.

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