Ongoing Neurological Assessments Reveal Subtle Changes

Article in Critical Care Nurse provides an overview of methods to assess patients with altered level of consciousness

Aug 02, 2023

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Article in Critical Care Nurse provides an overview of methods to assess patients with altered level of consciousness


ALISO VIEJO, Calif. - Aug 1, 2023 – Patients with altered level of consciousness are among the most difficult to assess and may have subtle neurological changes that can occur suddenly and become life-threatening if they go unnoticed.

Nurses who care for these patients must have the knowledge, skill and time to confidently perform comprehensive neurological assessments to identify changes that require quick diagnosis and intervention by the multidisciplinary team.

"Assessing Patients With Altered Level of Consciousness" discusses methods to assess these patients and describes the neurological assessment of and potential causes for altered level of consciousness. The article is published in the August issue of Critical Care Nurse (CCN).

Co-author Melissa Moreda, MSN, APRN, ACCNS-AG, CDCES, CNRN, SCRN, is an inpatient diabetes clinical nurse specialist at Duke Raleigh Hospital in North Carolina.

"Neurologically impaired patients are among the most vulnerable, often unable to communicate, advocate for, or defend themselves," she said. "Direct care nurses are at the forefront of care, and it's imperative to understand key components of an assessment and be able to evaluate trends rather than isolated events."

The article provides guidance for conducting a thorough neurological assessment, including:

  • General behavior and body position
  • Vital signs
  • Level of consciousness
  • Mental status
  • Motor control and sensory function
  • Cranial nerve function
  • Pupillary response
  • Language and speech
  • Reflexes
  • Cerebellar function

Many of the components of a neurological assessment are subjective, and changes in status may be subtle, requiring ongoing and astute monitoring. When minute changes are identified quickly, interventions critical for brain preservation can be implemented rapidly to prevent long-term complications and provide quality care for patients with altered level of consciousness.

As the American Association of Critical-Care Nurses' bimonthly clinical practice journal for acute and critical care nurses, CCN is a trusted source of information related to the bedside care of critically and acutely ill patients. Access the article abstract and full-text PDF by visiting the CCN website at http://ccn.aacnjournals.org/.

About Critical Care Nurse: Critical Care Nurse (CCN) a bimonthly clinical practice journal published by the American Association of Critical-Care Nurses, provides current, relevant and useful information about the bedside care of critically and acutely ill patients. The award-winning journal also offers columns on traditional and emerging issues across the spectrum of critical care, keeping critical care nurses informed on topics that affect their practice in acute, progressive and critical care settings. CCN enjoys a circulation of more than 128,000 and can be accessed at http://ccn.aacnjournals.org/.

About the American Association of Critical-Care Nurses: For more than 50 years, the American Association of Critical-Care Nurses (AACN) has been dedicated to acute and critical care nursing excellence. The organization's vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution. AACN is the world's largest specialty nursing organization, with about 130,000 members and over 200 chapters in the United States.

American Association of Critical-Care Nurses, 27071 Aliso Creek Road, Aliso Viejo, CA 92656; 949-362-2000; www.aacn.org; facebook.com/aacnface; twitter.com/aacnme