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ALTERED STATE OF CONSCIOUSNESS OIPF3KIWBQC (CAUSES (Neoplasms,…
ALTERED STATE OF CONSCIOUSNESS
DEFINITION
Depression of cerebral function occurs.
This ranges from stupor to coma.
PATHOPHYSIOLOGY
This occurs with the cerebral hemispheres.
Impaired arousal and awareness of consciousness occurs.
Cortical activity mediated awareness component.
This results to coma.
This occurs in the brain stem.
Using Glasgow coma scale coma is classified as:
No eye opening on stimulation.
Absence of comprehensible speech.
Failure to obey commands.
Reticular activating system mediates arousal of consciousness.
CAUSES
Neoplasms
Degenerative disorders eg Multiple Sclerosis
Trauma
Structural neurologic lesions
Hypoxemia
Epilepsy
Cerebral hemorrhage
Drugs
Lack of oxygen supply to the brain.
CLINICAL MANIFESTATIONS
Irregular heartbeat
Rapid pulse
Falling
Low blood pressure
Difficulty in walking
Fainting
Seizures
Fever
DIAGNOSTIC TESTS
Toxicology screen detecting presence and levels of:
Medication
Poisonous substances
Illegal drugs
Liver function test.
Complete blood count revealing:
Elevated WBC count indicating infections.
Low haemoglobin levels indicating anaemia.
Electroencephalogram evaluating brain activity.
Glasgow coma scale.
Electrocardiogram testing cardia's electrical activity
PHARMACOLOGICAL THERAPY
Administer prescribed amount of oxygen.
Naloxone for possible nausea and vomiting.
Dextrose for low blood glucose levels.
Thiamine as dietary supplement.
NURSING DIAGNOSIS
Impaired skin integrity due to diminished corneal reflex.
Impaired oral mucous membranes.
Decreased intracranial capacity.
Imbalanced fluid related to inability to ingest.
Impaired urinary elimination.
Ineffective airway clearance .
Bowel incontinence related to unconscious state.
Hyperthermia related to infections.
NURSING INTERVENTIONS
Maintaining skin integrity.
Regular position changes to eliminate pressure sores.
Position extremities in functional position .
Free skin from pressure.
Perform range-of-motion exercises .
Keep the skin dry, clean and well moisturised.
Eliminating fever.
Monitor temperature continuously.
Control persistent elevated temperature ranges.
Observe for possible sites of infection.
Attaining fluid and electrolyte balance.
Maintain hydration and enhance nutritional status.
Measure fluid intake and output daily.
Monitor prescribed intravascular fluids.
Evaluate parameters, pulses for circulatory inadequacies.
Promoting urinary elimination.
Use intermittent bladder catheterization for distention.
Monitor for cloudy urine.
Insert indwelling urinal catheter.
Facilitate bladder training program.
Maintaining effective airway.
Promote adequate gaseous exchange.
Facilitate drainage of respiratory secretions.
Position patient to prevent obstruction by tongue.
Suction using time intervals.
Promoting bowel function.
Palpate lower abdomen for distention.
Monitor for diarrhoea resulting from infection.
Auscultate for bowl sounds.
Monitor for constipation resulting from immobility.
Minimizing secondary brain injury.
Monitor response to pharmacological therapy.
Minimize risks resulting to increased intracranial pressure.
Identify any emerging trends on neurologic function.
Maintain normothermia.
Monitor neurological status of patient.
