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Lesson 22. General

2-22. GENERAL

a. Unconsciousness means that the patient is unaware of what is going on around him and is unable to make purposeful movement. The basic principle to remember is that the unconscious patient is completely dependent on others for all of his needs. Any omissions in basic nursing care or any failure to protect the unconscious patient in his helpless state may inhibit recovery or greatly prolong his convalescence because of complications that might have been prevented.

b. The most common causes of prolonged unconsciousness include:

(1) Cerebrovascular accident (CVA).

(2) Head injury.

(3) Brain tumor.

(4) Drug overdose.

c.      General nursing considerations:

(1) Always assume that the patient can hear, even though he makes no response.

(2) Always address the patient by name and tell him what you are going to do.

(3) Refrain from any conversation about the patient's condition while in the patient's presence.

d. Regularly observe and record the patient's vital signs and level of consciousness.

(1) Always take a rectal temperature.

(2) Report changes in vital signs to the professional nurse.

(3) Note changes in response to stimuli.

(4) Note the return of protective reflexes such as blinking the eyelids or swallowing saliva.

e. Keep the patient's room at a comfortable temperature. Check the patient's skin temperature by feeling the extremities for warmth or coolness. Adjust the room temperature if the patient's skin is too warm or too cool.

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