Change In Activity in Acute Illness

Q. What to Assess in Activity?
ACTIVITY of a person may be
a) INCREASED
b) DECREASED or
c) NO CHANGE

ACTIVITY DECREASED ⬇️ :-  Normally an active person, talkative person, fast moving person, becomes dull, inactive, quiet and slow. He either
1. just lies down not doing anything
2. Sleeps continuously.

The mother may point out that the child is sleeping today almost for 10 hours, and did not wake up to eat or to drink etc. In the above case

(a) the patient was dull though not sleepy; hence, we chose the first option.

1.Dull and just lies down.

Decreased activity is due to large amount of energy i.e. ATP from the mitochondria of the cell is being used up to combat the invader, or transfer the toxins from cell to cell by means of active transport.A

Activity Increased ⬆️ :-

This increase in activity can take place in physical sphere or mental sphere.

The mental activity can result in either mental anxiety or mental hyperactivity causing loquacity.

Thus, Increased Activity is
further divided into
a) Physical Restlessness (without mental Anxiety)
b) Mental Restlessness (with Anxiety)
c) Verbal Activity (Loquacity)

Physical Restlessness or Activity:-

Here, the patient just moves or is compelled to move by inner unknown urge.

The patient just does not sit in one place. Moves constantly; knows not for what.

He either paces the floor or goes out for walks just to keep moving.

Mental Restlessness or Activity:

Here, changes in the biochemistry of the patient make him ill- at-ease in mind hence, the patient becomes ANXIOUS. 

A child keeps on crying or becomes snappish or just becomes ununderstandably obstinate and starts kicking, striking, biting, etc.

an adult cannot bear anybody disturbing him or asking him questions all of which send him in a fit of Anger.

In short, the mental tolerance to all external stimuli is reduced causing the patient to go in a state of anxiety; a state of insecurity as to what will happen to me next?

Verbal Activity: In certain constitutions an acute illness can cause confusion in Wernicke’s area in the brain wherein due to unsynchronized impulses from the neighbouring areas, the interpretation area of Wernicke’s sends chaotic messages to Broca’s area of speech thus causing loquacity. This is
expressed in three forms
(a) Singing,
(b) Makes Verses and
(c) Cursing.

SINGING:- The patient, as the fever or toxicity rises becomes more exhilarated and rhythmic. He starts singing or talking in rhyming language.
Singing always does not mean actual singing song. He starts becoming rhythmic, starts substituting words from famous songs by his own words. “Jack and Jill went up the hill to fetch a pail of water!- nursery rhymes or a
famous film song is repeated again and again.

c) No Change:-

There are certain conditions which do not change under the ravages of acute infections or illnesses. This means there is no change in ACTIVITY of the patient. The patient has neither dulled nor become hyperactive.For all practical purposes these patients are the ones who tolerate their illness without complaining.

No complaint are be due to various causes
(a) because of contentment e.g. opium;
(b) because the patient is averse of pity sympathy from others e.g. Nat.
Mur.,
(c) or the patient does not want others being troubled for him nor does he
or she wants to miss his duities, work or school e.g. silicea.