Question

2. A new graduate nurse has come to the neurologic unit. It is her first day and she has full of questions. She comes to you and wants to know the classifications of level of consciousness (LOC) as it relates to assessing a client. She wants to know what the levels mean and if they are for only altered level of consciousness or everyone in the unit.

a. What are the levels of consciousness?

Answer 1

The patient generally who has neurological disorder, damage ,accidents, post surgical cases,etc.,are will be need of assessing the level of consciousness. In simple to know whether they are aware of self and surrounding or not . This aides in identifying the prognosis or detoriation of the patient from their disease condition.This helps to determine whether the patient is conscious or unconscious (competent or incompetent). The level of consciousness is graded in number from 1 to 15 .Here from 1-3 is fully unconsciousness and incompetent whereas 15 is full consciousness with competency.

It is categorized into three categories namely

• Eye opening (4) :
  • If spontaneous it is 4
  • If the patient opens eye in call it is 3
  • If patient doesn't respond to call ,pain stimulation is done to open eyes and then it will be 2
  • It will be scored 1if there is no response in all the above mentioned way
• Motor response (6):
  • If they respond to command ,grade 6
  • If the patient is capable of locating the site where pain is produced them grades 5
  • When movement is without any purpose then grade as 4
  • If the response is by flexing the limbs then grade 3
  • If the response is by extensing the limb then grade as 2
  • In case of no response them grade as 1
• Verbal response
  • When the patient respond appropriately grade as 4
  • If patient respond in a confused way then grade as 3
  • When there is inappropriate response or verbal response then grade as 2
  • Finally if patient do not verbalises to command then grade as 1