CH 5 Disorders of Consciousness

Question 1

What are the 3 generally accepted sub levels of DOC

Answer 1

coma, vegetative and minimally conscious

Question 2

What is the prevalence of DOC?

Answer 2

315,000 in U.S. (4,200/yr in veg state)

Question 3

How have assumptions for potential recovery changed?

Answer 3

used to think not appropriate for rehab
NOW there is potential for long-term recovery 2/2 examples of ppl who recovered, neuroimaging, understanding of neuroplasticity

Question 4

What are the characteristics of arousal?

Answer 4

Reflexive/generalized responses to int/ext stimuli RAS, primative and involuntary

Question 5

What are the characteristics of awareness?

Answer 5

Receive and process sensory info and use that info in intentional way, voluntary responses

Question 6

List 2 techniques in management for skin, lungs and bowel/bladder

Answer 6

Skin: turning/repo and incontinence mgmt
Lungs: trach for central apnea, positioning to prevent aspiration
B+B: meds for cons tip, catheters and infx prevention

Question 7

List 6 signs of imbalances in the autonomic nervous system

Answer 7

agitation
tacky
diaphoresis
hyperthermia
hypertension
tachypnea

Question 8

List 4 protocols for sensory stimulation modalities

Answer 8

-low distraction environment
-present stimuli 1 at a time
-vary stimuli to prevent habituation
-allow additional response time

Question 9

List 4 techniques in management of physical DOC issues

Answer 9

ROM
Orthotics
Upright positioning
Bed positioning (turn schedule)

Question 10

What is required for emergence from DOC?

Answer 10

functional communication (verbal/gestural)
Functional use of 2 or more objects

Question 11

What is a generalized response?

Answer 11

automatic, reflexive or non-purposeful (e.g. eye opening)

Question 12

What is a localized response?

Answer 12

not reflexive, voluntarily controlled response to stimuli (i.e. head turned to sound or withdraw from noxious stimuli)