Altered Mental Status Flashcards by Kiersten Harper

What does AVPU stand for

A - Alert, patient responds with appropriate words

V- Verbal, patient responds to verbal stimulation

P- Pain, patient opens eyes to pain

U- Patient is unresponsive

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What is the proper care for an attempted suicide?

Standby and scene size up
search for life threatening injuries
secondary assessment care and vitals
detailed exam if patient allows
reassess and monitor mood
contact hospital and report to police

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What is important to note in your assessment for a possible/attempted suicide?

•depression - take your patient seriously
•high current/recent stress levels
•recent emotional trauma
•age
•alcohol/drug abuse
•threats of suicide
•suicide plan
•previous attempts
•sudden improvement of depression

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What are the common causes of seizures in neonates?

•perinatal hypoxia and ischemia
•inter-cranial hemorrhage and trauma
•acute CNS infection
•Metabolic disturbances (hypo/hyperglycaemia)
•drug withdrawal
•development disorders
•genetic disorders

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What are the causes of seizures in infants and children (1month -12years)?

-febrile seizures
-genetic disorder
-CNS infection
-developmental disorders
-trauma induced
-idiopathic

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What are the causes of seizures for adolescents? 12-18

-trauma
-genetic disorders
-infection
-brain tumour
-illicit drug use
-idiopathic

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What is a behavioural emergency?

When behaviour is not typical for the situation or in unacceptable or intolerable. Patient may harm self or others.

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What are neurotransmitters?

chemicals within the body that transmits messages in the brain from distal end of one neuron to the proximal end of next neuron.

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What symptom will the body show when body temp is between 37-35°

shivering

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What symptoms will the body show when internal temp is between 35.5-32.7?

shivering, difficulty speaking

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What symptoms will the body show when internal temp is between 32-30?

shivering decreases, muscle rigidity, poor coordination, less alert, and out of touch

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What symptoms will the body show when internal temp is between 29-27?

irrational, out of touch, pulse and respirations slow

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What symptoms will the body show when internal temp is between 26-20

loss of consciousness, unresponsive, loss reflex, cardiac arrest

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What is conduction?

transfer of heat from one material to another- direct contact

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What is convection?

carrying away of heat by current air, water, other gases or liquids

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What is radiation?

sending out energy, heat in waves into space

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What are the 5 mechanisms of heat loss?

-convection
-radiation
-respiration
-evaporation
-conduction

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What is the proper care for hypothermia?

remove any wet clothes
actively rewarm patient
warm liquids at a slow rate
transport

Active rewarming - slow
central rewarm
keep patient at rest
be gentle

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What are the signs and symptoms of early cold injury?

-light skin reddened
-dark skin lightened
-area feels numb

What is the care for an early cold injury?

-get into warm area
-warm affected area
-splint and cover extremity

do mot massage or re expose to cold

What is the care for an Unresponsive Hypothermic patient?

-ensure open airway
-high concentration o2, warm water, humidifier
-wrap in blankets
-transport immediately

Where do you check pulse in hypothermic patient

carotid pulse

What are the signs and symptoms of a late or deep cold injury?

-skin is white and waxy
-mottled and blotchy skin
-white skin to grey
-yellow skin to blue
-swelling and blistering
-soft tissue death
-dark black skin

What are the proper steps of care in a late or deep cold injury?

1.oxygen
2.transport
3.warm
4.active rewarming
-warm water submerge
-als

What are the two types of rewarming, describe them?

central rewarming - application of heat onto chest, neck, armpits and groin Active rewarming - external heat sources to body

What are the signs and symptoms of Hypothermia?

-shivering -numbness -stiff/rigid posture -drowsiness -rapid breathing -loss of motor functions -joint or muscle stiffness -decreased Loc -cool and red skin

What are the signs and symptoms of a heat emergency?

•Muscle Cramps - legs/abdomen •Weakness/Exhaustion •Rapid, Shallow breathing •Weak Pulse •Heavy Perspiration •Loss of Consciousness •Pale, moist, cool skin

What is the care for a heat related emergency?

1.Remove Patient from heat 2. O2 if shocky 3. Loosen clothing, watch for shivering 4. supine position, keep resting 5. Small Sips of water 6. Lay on left side 7. Moist towels for muscle cramps 8. Transport

What is the proper care for an animal/insect bite or sting?

1. Treat for shock (O2, warm, supine) 2. Call medical direction if animal is unknown or super venomous 3. remove stinger or sac 4. remove jewelry 5. place hands/ tourniquet to prevent venom spread 6. immobilize limb that was affected

What are the signs and symptoms for a bug bite or sting?

-altered LOC -bites/stings -puncture marks -blotchy skin -pain/itching -numbness -burning -redness -swell/blisters -weakness -headache -chills -fever -nausea/vomiting -muscle cramps, chest, tightness, joint pain -saliva/drooling -sweating

What are the physical causes of Altered Mental Status?

-low blood sugar -lack of oxygen -stroke/inaccurate blood flow to brain -head trauma -seizures -mind altering substances -environmental temperature changes

What is the proper treatment for hypoglycaemia?

1.Maintain Airway 2.Vitals and Blood glucose 3. Oxygen 4. Glucose paste 5. Suction 6. Glucagon 7. Retake Blood glucose 8. Consider ALS 9. Reassess

What is the care for hyperglycaemia?

1. Maintain Airway 2. Vitals and glucose 3. 02 if needed 4. ALS 5. Position of comfort 6. monitor vitals

What are the signs and symptoms of hyperglycaemia?

-thirst -headaches -tired -weak -cramps -dizzy -eyesight blurred -nauseous -constantly peeing -ketones on breath

what are the causes of seizure for adults 18-35?

-trauma induced -alcohol withdrawal -illicit drug use -brain tumour -idiopathic (unknown)

what are the causes of seizures in adults 35+

-cerebrovascular disease -brain tumour -alcohol withdrawal -metabolic disorders -alzheimer’s disease -degenerative CNS disease -idiopathic

Explain the generalized tonic/clonic seizure…

Tonic - 1/2 mins 1.loss of consciousness 2.fall ~ tonic stiffening 3.cry ~ bladder control altered Clonic - 1/2 mins 1. jerking of limbs 2. salivary frothing Postictal- hours 1. patient is lethargic and confused

What is status epilepticus?

a seizure that lasts more that 5 minutes OR a more than 1 seizure in 5 minutes

What are the signs and symptoms of heat stroke?

-loss of consciousness -rapid, shallow, breathing -full rapid pulse -weakness -little to no perspiration -dilated pupils -seizures

What is the proper care for heat stroke?

1. remove from hot environment 2. remove clothes and apply cool packs, keep skin wet 3. high 02 4. transport immediately

what kind of breathing will diabetic attacks present to breathe off ketones?

kussmal breathing

What will cause a diabetic to go into a low blood sugar dip?

-take too much insulin -reduces sugar intake -over exercises -vomits -fever/shivering

what are the signs and symptoms of hypoglycaemia?

-hungry -confused -dizzy -grumpy -shakey -sweaty -headache

what is type one diabetes?

-immune cells destroy beta cells in the pancreas -pancreas cannot produce insulin -more glucose in blood

what is type two diabetes?

-pancreas produces less insulin -less glucose in cell, more in blood