Scribd Logo
Upload

Welcome to Scribd!

  • 58 views

    Altered Level of Consciousness

    Uploaded by

    Marissa Asim
    This document discusses altered levels of consciousness and increased intracranial pressure. It defines consciousness as requiring awareness and arousal, and describes how the Glasgow Coma Scale is used to assess levels of consciousness. Increased intracranial pressure occurs when pressure inside the skull rises above 15 mmHg due to factors like head injury or brain swelling. Early manifestations of increased ICP include deterioration in consciousness, vital signs, pupil response, and vision. Management focuses on maintaining airway, fluids/electrolytes, monitoring ICP and vital signs, and preventing complications through medications like mannitol which reduce ICP by drawing fluid from the brain.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Altered Level of Consciousness

    Uploaded by

    Marissa Asim
    58 views3 pages
    This document discusses altered levels of consciousness and increased intracranial pressure. It defines consciousness as requiring awareness and arousal, and describes how the Glasgow Coma Scale is used to assess levels of consciousness. Increased intracranial pressure occurs when pressure inside the skull rises above 15 mmHg due to factors like head injury or brain swelling. Early manifestations of increased ICP include deterioration in consciousness, vital signs, pupil response, and vision. Management focuses on maintaining airway, fluids/electrolytes, monitoring ICP and vital signs, and preventing complications through medications like mannitol which reduce ICP by drawing fluid from the brain.

    Original Title

    LEVEL-OF-CONSCIOUSNESS

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document discusses altered levels of consciousness and increased intracranial pressure. It defines consciousness as requiring awareness and arousal, and describes how the Glasgow Coma Scale is used to assess levels of consciousness. Increased intracranial pressure occurs when pressure inside the skull rises above 15 mmHg due to factors like head injury or brain swelling. Early manifestations of increased ICP include deterioration in consciousness, vital signs, pupil response, and vision. Management focuses on maintaining airway, fluids/electrolytes, monitoring ICP and vital signs, and preventing complications through medications like mannitol which reduce ICP by drawing fluid from the brain.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    58 views3 pages

    Altered Level of Consciousness

    Uploaded by

    Marissa Asim
    This document discusses altered levels of consciousness and increased intracranial pressure. It defines consciousness as requiring awareness and arousal, and describes how the Glasgow Coma Scale is used to assess levels of consciousness. Increased intracranial pressure occurs when pressure inside the skull rises above 15 mmHg due to factors like head injury or brain swelling. Early manifestations of increased ICP include deterioration in consciousness, vital signs, pupil response, and vision. Management focuses on maintaining airway, fluids/electrolytes, monitoring ICP and vital signs, and preventing complications through medications like mannitol which reduce ICP by drawing fluid from the brain.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    You are on page 1of 3

    LEVEL OF CONSCIOUSNESS  Assess ability to obey or respond to

    Altered Level of Consciousness command


    Consciousness-a state when these 2  Record GCS frequently (refer
    factors are present: accordingly)
     Assess motor nerve reflexes
    1. Awareness - Mediated by the cortical  Assess Vital signs
    activity in the cerebral hemispheres  Assess cranial nerves
    (cerebrum)  Perform head-to-toe assessment
    2. Arousal - Mediated by the reticular
    activating system in the brain stem Management
     Prevent secondary brain injury
    Unconsciousness  Monitor for signs of complications,
     A condition when there is depression progress or deterioration
    in cerebral function that may range  Minimize risk for increased
    from stupor to coma intracranial pressure, etc.
     COMA results
     when there is impairment in both Management
    awareness and arousal  Maintain patent airway
     Attain and maintain fluid and
    The GLASGOW Coma Scale electrolyte balance • Maintain good
    •A tool that is used to assess the level of oral mucous membrane
    consciousness  Maintain skin integrity
     Maintain corneal integrity
    Altered LOC may be due to:
     Maintain body functioning - urination,
     Hypoxemia
    defecation, circulation
     Trauma
     Prevent infection
     Vascular disorders
     Neoplasm Increased Intracranial Pressure
     Degenerative and infectious disorders  Intracranial Pressure is the pressure
     Metabolic and neurologic conditions, exerted by the contents in the cranial
    etc. vault.
    Note:  ICP is measured in millimeters of
    • Perfect score=15 mercury (mmHg) and is normally 7-
    • A score of 7 and below = COMA 15 mmHg for a supine adult at rest
    • Change of 2 in the previous assessment =
    significant 3 Components in the Cranial Vault:
    • GCS - used to assess LOC: this is not used to
    measure the IQ of a person • Exist in the following ratio:
    1. Brain tissue = 80%
    Consciousness 2. CSF = 10%
    s a state that involves 2 important 3. Blood volume/ pressure: = 10%
    components: TOTAL: 100%
    1. Awareness Concepts:
    2. Arousal
    Altered Level of Consciousness  The pressure relationship of the 3
    Assessment: elements constantly adjust to achieve
     Assess level of responsiveness an acceptable steady equilibrium.
     An increase in the volume of one A. Changes in behavior restless in able,
    component results in the decrease in drowsy
    the volume of the other components B. Changes in level of orientation O
    (COMPLIANCE) C. Inability to follow commands
     When compliance is poor, increased D. Difficulty with verbalization E. Changed
    ICP occurs. response to painful stimuli
    F. Abnormal posture.
    Increased-ICH
     When the intracranial pressure Manifestations
    becomes greater than 15 mmHg = 2. Deterioration in Vital signs
    Increased ICP A. Widening pulse pressure
    B. Rising blood pressure
    This may result from: C. Pulse changes - bradycardia to tachycardia
     head injury D. Respiratory changes tachypnea. Cheyne-
     cerebral edema Stokes respi Kussmaul's respiration
     abscess and infection E. Temperature may be moderately elevated
     Lesions
     Intracranial surgery Manifestations
     radiation therapy. 3. Pupillary/Visual Changes

    Pathophysiology A. Unequal pupil sizes B. Semi-dilated pupils


    Brain, CSF, Blood pressure fAll cranial vault to or non-reactive pupils
    capacity C. Presence of retinal hemorrhage or
    / papilledema
    Increase in the volume of one or more of the D. Blurred to no vision
    components (NORMALLY: must result in E. Glare, unconjugated eye movement
    decrease in volume of the other components) F. Absent doll's eyes sign
    /
    Failure of the oth component to compensate Manifestations
    (Poor compliance) 4- Other Changes
    / A. Headache that is increasing in intensity,
    Increased Intracranial Pressure bulging fontanel in infants and young
    / children
    When ICP Increases, the brain compensation B. (Projectile) Vomiting without antecedent
    / nausea
    Displacement/ shunting = of the CSF from the C. Motor and sensory dysfunctions
    intracranial compartment to the lumbar D. Contra lateral hemiparesis (progressing to
    subarachnoid space hemiplegia)
    / E. Speech impairment
    Increasing the absorption of CSF F. Cranial nerve deficits
    / G. Pathologic reflexes: Babinski reflex,
    Decreasing cerebral volume by displacement changes in grasp, chewing, sucking reflexes
    of cerebral venous blood into venous sinuses
    / Management
    Increasing the compliance • Establish and maintain airway
    • Mechanical ventilation
    Manifestations • Maintain indwelling catheter
    1. Deterioration in LOC (use GCS)
    • Fluids - electroly balance • Monitor ICP and
    vital signs
    • Prevention of hypoxia, fever and other
    complications

    Administer drugs:

     Osmotic - diuretics (Mannitol)


     Corticosteroids
     High dose barbiturates Beizures)
     Mannitol
     Is an osmotic - diuretic

    It increases osmotic pressure of glomerular


    filtrate, inhibiting tubular reabsorption of
    water and electrolytes: It elevates plasma
    osmolality, increasing water flow into
    extracellular fluid.

    • Give as infusion, DO NOT As direr injection

    • WATCH OUT: Oliguria, Fluid imbalance,


    Electrolyte imbalance, heart failure.

    You might also like