RLA Levels of Consciousness/ Cognitive Fn

Question 1

RLA I: No response

Answer 1

DOC - coma-usually less than 2-4 wks unless chronic
- complete absence of observable response to ANY stimuli
-complete lack of arousal (not spontaneous or by stimuli)
-reflex driven

Question 2

RLA-R: Level II Generalized Response: Total Assistance

Answer 2

DOC: Vegetative State (persistent if lasts 1 year)
-Generalized reflex response to painful stimuli (gross movement/sound), need repetitive stimuli
-response isn’t dependent on stimulus
-no evident awareness of self/environment
-spontaneous or stimulated arousal
-sleep/wake

Question 3

-INTERACTS w/ stimuli
-withdrawal and vocalization to painful stimuli
-turns toward/away from auditory stim
-blinks @ strong light in visual field
-follows moving objects
-inconsistent response to command

Answer 3

RLA-R: Level III; Localized Response: Total Assistance

Question 4

-orientation: complete confusion
-memory: absent STM
-problem solving: inconsistent familiar: unable for new
-attention: brief, non purposeful
-communication:incoherent and/or inappropriate
-behavior: exaggerated, agitated, impulsive

Answer 4

RLA-R IV: Confused-Agitated: Maximal Assist

Question 5

RLA-R V: Confused, Inappropriate-Non Agitated: Maximal Assist

Answer 5

orientation: still confused
memory: no STM, conflicts past/present
attn:highly distractible
communication: inappropriate, confabulating, tangential
behavior: alert (not agitated), impulsive w/o goal-direction

Question 6

RLA-R VI: Confused, Appropriate: Moderate Assist

Answer 6

orientation: inconsistent
memory:STM impaired but improving, aids w/ max (A)
attn: highly familiar tasks in closed environment (30m w/ assist)
problem solving: supervision for old tasks, no carryover
communication: simple directions, appropriate if familiar
behavior: unaware of impairment, urgency but recognizes basic needs

Question 7

RLA-R VII: Automatic, Appropriate: Minimal Assist

Answer 7

orientation:consistent w/ mod assist for time
memory: carryover w/ new info, aides w/ mod (A)
attention: highly familiar tasks in closed environment (30m+ w/ min assist)
problem solving:min (A) w/ new learning
communication: multi-step w/ support, verbal response automated but appropriate
behavior:superficially self aware, unrealistic goals, opposition

Question 8

orientation: consistent
memory: integrate past/present, memory devices w/ SBA
attention: independent task completion for 1 hr
problem solving:initiates and executes familiar, can modify plans
communication- more fluid convo, multi-step w/ support
behavior:depressed, irritable, self-centered, min (a) to correct inappropriate intrxns

Answer 8

RLA-R VIII: Purposeful, Appropriate: Stand-by Assist

Question 9

orientation: consistent
memory: independently uses devices w/ some help to maintain
attention: 2hr min
problem solving: indep routines, request assistance w/ new
communication: more fluid convo, multi-step w/ support
behavior:depressed, irritable, self monitor appropriateness w/ SBA

Answer 9

RLA-R IX: Purposeful, Appropriate: Stand-by Assist on Request

Question 10

orientation: connsistent
memory: independent
attention:multiple tasks in all environment, may need break
problem solving: indep w/ routine, accomodation/ compensates new
communication: spontaneous and appropriate
behavior: occasional depression, appropriate irritability, self monitor appropriateness w/ SBA

Answer 10

RLA-R X: Purposeful, Appropriate: Stand-by Assist on Request