Explain/Define Altered level of consciousness.

Consciousness level means any person is aware of himself and the environment around him, it is called consciousness of the person.

Arousal of a person in Altered Level of Consciousness is seen as different from that of a normal person.

That is, the arousal of a person is seen to be altered in the stimuli of the external environment.

Altered level of consciousness means when any person is unaware of himself and his surrounding environment (time, place, person) it is said that the consciousness of a person is altered.

Altered level of consciousness is classified as follows.

1) conscioussness (consciousness),

2) Confusion,

3) Lethargy,

4) Obtunded,

5) Stuper,

6) Coma.

1) conscioussness,

In the state of consciousness, a person is aware of himself and his surrounding environment and time, place and person.

2) Confusion,

In a state of confusion, a person is not oriented to time, place and person and cannot think rapidly and his attention span is short.

3) Lethargy,

In the lethargy state, the person is slightly depressed with conscioussness, but in this stage, the person is oriented to the time, place and person.

4) Obtunded,

In this stage the person feels very drowsy and can follow simple commands when a stimulant is provided.

5) Stuper,

In this stage the individual is not properly arousal but follows the command only when painful stimuli are provided.

6) Coma.

A person in the coma stage cannot provide an appropriate response to environmental stimuli. Unarousable conditions are present in this stage.

Explain the Etiology/cause of the Altered level of consciousness.

Due to traumatic brain injury.

Due to infection.

Due to metabolic disorder.

Due to intoxication.

Caesar.

stroke.

hypoxia.

Neurological disorders like epilepsy,

Multiple Sclerosis, Certain tumor.

Due to psychiatric condition.

Due to alcoholic and substance abuse.

Due to low blood sugar.

Explain the Clinical manifestation/ sign and symptoms of the patient with the Altered level of consciousness.

Decreased responsiveness.

Confusion.

Disoriented.

Memory Impedance.

Abnormal motor response.

Changes in speech.

Changes in pupillary response.

Abnormalities in vital signs are observed.

Caesar is coming.

Being an abnormal poster.

Loss of bowel and bladder control.

Explain the diagnostic evaluation of the patient with the altered level of consciousness. (State the diagnostic evaluation of a patient with altered level of consciousness.)

History taking and physical examination.

CT-scan.

MRI

Cerebral angiography.

Doppler study.

Serum electrolyte assessment.

ABG IS DONE.

Toxicology screening.

CSF Analysis.

Blood test.

Neurological assessment.

Laboratory Studies.

Electroencephalogram (EEG).

Toxicology Screening.

Explain the medical management of the patient with the altered level of consciousness. (State the medical management of a patient with altered level of consciousness.)

Provide supportive care to the patient.

Assess the patient’s airway, breathing and circulation properly.

To properly monitor the patient’s vital signs.

Perform neurological assessment of the patient properly.

Identify the cause of the patient’s disease and treat it early.

If the patient has any infection, provide him with proper antibiotic medication.

If the patient has condition of seizure then provide antiepileptic drug to the patient.

Antipyretic medicine should be administered if the patient has a febrile condition.

Maintaining patient’s fluid and electrolyte balance.

Provide proper fluids to the patient.

Provide proper nutritional support to the patient.

Advising the patient to take proper measures to prevent complications.

To provide proper rehabilitation therapy to the patient

Provide proper physical therapy, occupational therapy, speech therapy to the patient.

Provide proper psychological support to the patient.

Advising on proper follow up of the patient.

Explain the nursing management of patients with the altered level of consciousness. (Give nursing management of patient with altered level of consciousness.)

Properly assess the patient.

Properly assess the patient’s level of consciousness.

Keeping the patient’s airway properly patent.

Provide oxygen to the patient properly.

If the patient is intubated then do proper suctioning.

Changing the position of the patient properly every 2 hourly.

Provide postural drainage to the patient.

Assess whether the patient has gag reflex or not.

Assess the neurological status of the patient properly.

Provide proper side lining position to the patient.

Provide proper side lying position and change position frequently to prevent the patient from pressure ulcer.

Assess all pressure points of the patient properly.

Providing proper comfort device to the patient.

Advise the patient to perform range of motion exercises.

To properly maintain the nutritional status of the patient.

Provide high calorie and high protein diet to the patient.

Advising patients to take proper medication.

To provide complete information to the patient’s family members about the patient’s disease, its symptoms and signs, its causes, and its treatment.

Maintain proper patient safety.

Properly collaborating with other health care personnel for the treatment of patients.

Provide proper psychological support to the patient and his family members.