Dr. House
This condition causes an altered LOC, hypoactive or hyperactive symptoms, has a sudden or progressive onset, fluctuating symptoms, and is assessed for every shift.
What is delirium
This is the standardized scale used to determine the level of consciousness in patients.
What is the Glasgow Coma Scale
What acronym do we use to identify a stroke?
What is BEFAST: Balance, Eyes, Facial Droop, Asymmetry, Speech, Time
Your fresh post-op patient has a swollen left arm below their IV site, it is red, and they are complaining of pain. It is also warm to touch.
What is a DVT?
A 74-year-old patient becomes acutely lethargic,
RR 8, BP 82/40, SpO₂ 85%,
What is airway support and oxygen administration? Airway and oxygenation take priority over diagnostics; hypoxia and hypotension rapidly worsen cerebral perfusion. Then check blood glucose level.
Your day 1 post op patient is complaining of 8/10 pain to the incision site and chills. Their WBC jump from 13 to 27. Temp: 38.4, RR 27, HR 114, SpO2 91% on RA.
What is Sepsis
This lab value is the first to be checked in any patient with an altered LOC.
What is blood glucose? Hypoglycemia mimics focal neurological deficits.
You find your full code patient unresponsive in bed with no visible respirations, what do you do?
What is call a code blue, start CPR
Your patient with an altered LOC has a rapid improvement in their LOC after receiving dextrose.
What is hypoglycemia?
You patient has an epidural and you have not completed the ice test since starting your shift. You go in to do vitals and their RR is 11 and SpO2 is 91%. What do you do
Your patient just arrived in Canada yesterday from Mexico. They have COPD with a history of cancer. They develop sudden onset SOB and chest pain, HR 114, SpO2 85% on 4L. What is happening?
What is a pulmonary embolism
By administering 1L IV bolus, you may notice an improvement in level of consciousness and correct this hemodynamic instability.
What is hypovolemia? ** or Hypotension
An MTP is called overhead to the OR - what Med-Surg nurses must respond?
What is Med-Surg RPN goes to code
Med-Surg RN goes to ED to cover
In older patients, this may present as the first sign of sepsis.
What is altered LOC
*also tachypnea
Your patient is lethargic, moaning and blood sugar is 2.5
What is give an AMP of Dextrose
A patient becomes lethargic and is abdominal breathing. VBG shows pH 7.28, PCO₂ 72, HCO3 27. What is the cause of altered LOC?
What is hypercapnia?
Hypercapnia depresses the CNS and causes progressive somnolence; treatment focuses on improving ventilation, not oxygen alone.
Treatment: BiPap
On lung auscultation you find course crackles throughout the lungs with SOB, RR 24. You also notice +2 pitting edema in the lower extremities. IV fluids are running continuously at 125mL/hr. What do you do?
What is stop the IV fluids and notify the MRP about fluid overload
You called a code stroke on your patient, the MRP wants to order a CT head in house, what do you advise them?
This condition presents with altered LOC such as agitation, diaphoresis, hallucinations and tremors.
What is alcohol withdrawal?
You find your patient on the floor with blood coming from their head. They are not following commands appropriately and cannot move their legs on their own.
What is call the ED doc for spinal precautions
On assessment of your patient, you find the patient has an altered LOC, hypotensive, tachycardic, with oliguria and cool clammy skin, all signs of this state.
What is Shock
Shock results in decreased cerebral perfusion due to the reduced MAP, and decreased cerebral blood flow
This vital sign abnormality worsens cerebral perfusion in sepsis
What is hypotension – Low MAP decreases cerebral blood flow resulting in an altered LOC
A code blue was called off of your unit, you're the starred RN, where do you go?
What is ED
Your patient admitted with a pain crisis is lethargic with pinpoint pupils, their speech is garbled, and their RR is 14
What is narcotic overdose?
You patient has a NEWS2 score of 5. What do you do?
Confirm NEWS2 Score, and reassess in 1 hour