CVA Impairments 3: Consciousness/Cognition/Communication Flashcards
Your patient is very difficult to arouse and has a dulled sensitivity to stimulation. You would document their level of consciousness as:
Obtundation
Your patient is in a semi conscious state and requires intense stimulation to elicit any response. You would document their level of consciousness as:
Stupor
Your OT teammate says your next patient is lethargic, what do you expect when you walk into the room?
The Pt is generally arouseable yet slow in cognition and motor processes.
Eye Response Scoring for GCS
4 - spontaneous
3 - verbal
2 - pain
1 - none
Verbal Response Scoring GCS
5 - oriented
4 - confused
3 - inappropriate
2 - incomprehensible
1 - none
Motor Response Scoring GCS
6 - Obeys command
5 - purposeful movement
4 - withdrawals from pain
3 - decorticate posture
2 - decerebrate posture
1 - none
Total GCS scores are found to predict acute mortality with an 88% accuracy at _______ and ______.
2 weeks and 3 months.
With cognition and communication deficits being so comm CVA - how are GCS scores charted?
The verbal component can be excluded when appropriate without loss of predictive value.
What is an often overlooked intervention that can help with impaired consciousness in CVA patients?
Patient positioning (get them up to wake them up!)
What cognition impairment is associated with balance impairments and falls?
Attention
Your patient has impaired cognition, how will you adapt during therapy session?
Increased cues and redirection encouragement
Your patient appears to be a in a good mood when you grab them from their room for your session. They begin crying hysterically while telling you they are enjoying walking again. Later in the session they are yelling at you angrily. You suspect what behavioral dysfunction?
Pseudobulbar affect
Alexia
Impairment in reading ability
Agraphia
impairment in writing ability
Alexia without aphasia
lesion to DOM occipital cortex extending into posterior corpus callosum (PCA)
