Health Questions and Answers

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

Answer:

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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