Care of Unconsciousness patient

1. Care of Unconsciousness patient

2. INTRODUCTION • Unconscious patients have no control over themselves or their environment and thus are dependent on the nurse. Therefore a nurse in critical care unit/Intensive care unit needs to be abreast with appropriate knowledge and right attitude on how to care for the unconscious patient.

3. DEFINITION OF TERMS • Consciousness: Consciousness is the state of general wakefulness and responsiveness to the environment. • Sleep:Sleep is the state of altered consciousness or partial unconsciousness from which an individual can be aroused. • Unconsciousness : Unconsciousness is the state of unresponsiveness, where the patient is unaware of the environment and no purposeful response can be obtained. • Coma: Coma is a clinical state of unconsciousness in which the patient unaware of self and environment and an individual cannot be awakened.

4. Care of Unconsciousness patient

5. Maintaining patent airway • Elevating the head end of the bed to 30 degree prevents aspiration. • Positioning the patient in lateral or semi prone position. • Suctioning. • Chest physiotherapy. • Auscultate in every 8 hours. • Endo tracheal tube or tracheostomy.

6. Protecting the client • Padded side rails • Restrains. • Take care to avoid any injury. • Talk with the client in-between the procedures. • Speak positively to enhance the self esteem and confidence of the patient. 

7. Maintaining fluid balance and managing nutritional needs • Assess the hydration status. • More amount of liquid. • Start IV line. • Liquid diet. • NG tube.

8. Maintaining skin integrity • Regular changing in position.  • Passive exercises.  • Back massage. • Use splints or foam boots to prevent foot drop.  • Special beds to prevent pressure on bony prominences.

9. Preventing urinary retention • Palpate for a full bladder.  • Insert an indwelling catheter. • Condom catheter for male and absorbent pads for females in case of incontinence.  • Inducing stimulation to urinate.

10. Providing sensory stimulation • Provided at proper time to avoid sensory deprivation. • Effort are made to maintain the sense of daily rhythm by keeping the usual day and night patterns for activity and sleep. • Maintain the same schedule each day. • Orient the client to the day, date, and time accordingly. • Touch and talk. • Proper communication. • Always address the client by name, and explain the procedure each time.

11. Family needs • Family support. • Educate the needs of client. • Care to be provided.

12. Potential complications • Respiratory distress • Pneumonia • Aspiration • Pressure ulcer