Sensorium (unconsciousness)
- 2. INTRODUCTION The totality of those parts of the brain that receive, process and interpret sensory stimuli. The sensorium is the supposed seat of sensation, the place to which impressions from the external world are conveyed and perceived. The sensorium also refers to the entire sensory apparatus of the body.
- 3. DEFINITION The totality of those parts of the brain that receive, process and interpret sensory stimuli. The sensorium is the supposed seat of sensation, the place to which impressions from the external world are conveyed and perceived.
- 4. ALTERED SENSORIUM The term altered sensorium describes limitation on or problems with the brain’s ability to receive, process or interpret sensory information, Ex- altered sensorium include hallucinatory and confusional states , delirium , coma and sleep.
- 5. Care of unconscious patient It is a lack of awareness of one’s environment and the inability to respond to external stimuli. Unconsciousness is a condition where cerebral functions are depressed and patient has inability to respond to sensory stimuli. A coma is a state of unconsciousness.
- 6. causes Head injury Cerebral catastrophes. Infection Asphyxia Poisons.
- 7. Types 1. brief , lasting for a few seconds or an hour. 2. sustained , lasting for a few hours.
- 8. Investigation Blood test for glucose, urea nitrogen, electrolytes and ph value Complete blood count Lumbar puncture for cerebrospinal fluid examination. Liver function tests. X-ray of skull Electroencephalography.
- 9. Assessment Physical assessment. Glasgow coma scale. Eye opening-spontaneous 4 to speech 3 to pain 2 no response 1 Verbal response-oriented 5 confused 4 inappropriate words 3 Incomprehensible sound 2 no response 1
- 10. Motor response Obeys commands 6 Localize 5 Withdraws 4 Flexes 3 Extends 2 No response 1 Total score - 3-15
- 11. Treatment Respiration should be maintained by patient airway. The passage should cleared of secretion. If necessary oxygen should be administered. Blood gas studies should be monitored.
- 12. If the patient in the shock, it should be treated. Reduce the intracranial pressure – A) ventricular tapping to remove the csf. B)burr hole to monitor intracranial pressure. C)use of osmotic diuretics to relieve tension caused due to cerebral oedema. Ex. Mannitol.
- 13. Antibiotics are necessary , to treat infections. Sedatives are prescribed for the restless patients Stool softer may be required to prevent constipation. Specific treatment should be started early.
- 14. Nursing management. constant observation Vital signs Complications. Respiration by airway Semi prone position on one side Suction Cleared secretions Facilitated ventilation According to level consciousness observed sign – reflexes , responses.
- 15. Cerebral edema should be prevent by diuretics Eye care protect from injury Prevent pressure sores Prevent constipation Deformities should be prevent
- 16. Nursing process
- 17. Assessment Evaluation of mental status Cranial nerve functioning Reflexes Motor and sensory functioning Scanning , imaging , tomography electroencephalogram Glasgow coma scale.