25 - Adult - ALOC

Question 1

Vitals in the ALOC patient should be evaluated every ____ minutes.

A. 5
B. 10

Answer 1

A. 5 minutes

Even if the patient appears “stable,” they may change rapidly.

Question 2

Causes of suspected mental status changes are remembered by what mnemonic?

Answer 2

A — Alcohol/Acidosis
E — Endocrine/Epilepsy/Electrolytes/Encephalopathy
I — Infection- meningitis, encephalitis, sepsis, septic shock; pneumonia, urinary tract infection, occult osteomyelitis.
O — Opiates, Overdose
U — Uremia/Underdose

T — Trauma - head injury, blood loss (shock).
I — Insulin
P — Poisoning/Psychosis/pharmacology
S — Stroke/Seizure/syncope

Question 3

S/S of hypoglycemia.

Answer 3

“Cool and moist” like inside of apple

• pale
• diaphoretic
• cool

Question 4

S/S of hyperglycemia.

Answer 4

“Hot and red” like outside of apple

• red color
• dry skin
• warm to touch

Question 5

T/F: a patient with signs of hypoglycemia who is diabetic with a BGL of under 80 mg/dL may be given dextrose.

Answer 5

Correct. These diabetics may be hypoglycemic even if they have a “normal” blood glucose level.

Question 6

Form of glucose for adult hypoglycemics not in cardiac arrest.

Answer 6

D10 drip, 5mL/kg

Question 7

Medication for adult hypoglycemics not in cardiac arrest in whom IV access is not obtainable.

Answer 7

Glucagon, 1 mg IM

Question 8

If the ALOC patient has a blood glucose of “Hi,” what may be given? What is the lower limit of “Hi” in BGL monitors?

Answer 8

20 mL/kg NS bolus; repeat x1 if CBBS

Hi = >300 mg/dL

Question 9

If the ALOC patient does not respond to glucose/glucagon after 2 minutes, what is administered next?

Answer 9

2-4 mg IV/IN/IM Narcan