Health Questions and Answers

Question: What is the significance of other vital signs in patients with altered mental status?


Check the cardiac monitor. Bradycardia or arrhythmias can alter cerebral perfusion and cause altered sensorium. Carefully count respirations. Tachypnea may indicate the presence of hypoxemia or a metabolic acidosis, and diminished respiratory efforts may require assisted ventilation. Check the blood pressure. Do not assume that hypotension has a CNS cause. Look for hypovolemia or sepsis as a cause for hypotension, but remember that adults (in contrast to infants) cannot become hypovolemic from intracranial bleeding alone. Hypertension may be a result of increased intracranial pressure, but uncontrolled hypertension also may cause encephalopathy and coma. Do not forget to obtain the fifth vital sign–measurement of oxygen saturation with a pulse oximeter.

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