altered mental status stuff

Question 1

causes of ams

Answer 1

• hypoxia, glucose, water deficiencies, trauma
• sepsis, seizures
• ask family memebers about baseline mental status

Question 2

diabetes mellitus

Answer 2

• type 1: pancreatic cells not functioning properly, insulin not secreted normally (not enough)
• type 2: body’s cells fail to utilize insulin properly (enough, not used)

Question 3

hyperglycemia

Answer 3

low blood sugar
too much insulin taken
seems drunk

Question 4

hyperglycemia

Answer 4

high blood sugar
too little insulin
nausea, peeing
diabetic ketoacidosis

Question 5

diabetic ketoacidosis

Answer 5

• shock (dehydration)
• rapid breathing
• acetone odor on breath
• altered ms

Question 6

hypo vs hyper glycemia

Answer 6

hypo is faster onset
hyper warm red dry skin
hypo clammy skin
hyper acetone breath

Question 7

glucometer

Answer 7

• less than 60 mg/dl in symptomatic diabetic: hypoglycemia
• less than 50 mg/dl prolly also ams
• changes per pt
• 80-120 is standard
• > 140 is hyperglycemia
• > 100 for too long causes dehydration
• hi: >500
• low: <15

Question 8

seizures

Answer 8

partial: may stay conscious, part of brain
generalized: unconscious, whole brain
tonic phase:rigid
clonic phase: shaking
posticial phase: regain consciousness
some precede seizures by aura
-bc of hypoxia, stroke, brain injury, toxins, hypoglycemia, tumor, infection, idiopathic, epilepsy

Question 9

status epilepticus

Answer 9

-2 or more convulsive seizures in a row without regaining consciousness

Question 10

generalized seizures

Answer 10

tonic clonic

absence (petit mal) seizures: brief w/out dramatic motor activity, loss of concentration

Question 11

stroke

Answer 11

-hemiparesis
-difficulty to speak
-headache caused by burst vessel in head
-impaired vision
-one side paralysis
-aphasia
stroke scale: smile, hold out arms, repeat sentence

Question 12

stroke what to do

Answer 12

-monitor airway
-high conc oxygen, transport
-transport to stroke center! has a ct!
ct to see if schemic:clot or hemorraghic(no clot meds just bleed more)
-document exact time of onset of symptoms, get phone # of fam member w that info

Question 13

dizziness and syncope

Answer 13

• can be sign of serious injury
• vasovagal: stimulation of vagas mervenmakes heart slow
• hypovolemic
• tachy brady cardia
• metabolic