SRI RAMANA MAHARSHI COLLEGE OF NURSING, TUMKUR

SUB: NURSING FOUNDATION

LESSON PLAN ON

CARE OF UNCONSCIOUS
PATIENT
 BACKGROUND INFORMATION

Name of the educator :

Subject : Nursing foundation
Unit : XTH
Place : 1st Year B.Sc Nursing Class Room
Group : 1st Year B.Sc Nursing Students
Date and time :
Method of teaching : Lecture, Discussion, Demonstration
Instructional aids : PPT, Black board.
Instructional medium : English
Duration : 01 hr
Previous knowledge of the group : The Group Has Previous Knowledge Regarding Topic
GENERAL OBJECTIVES:

At the end of the class students attain knowledge regarding care of unconscious patient

SPECIFIC OBJECTIVES:

At the end of the class students will able to ,

 introduce about unconsciousness

 define unconsciousness
 List out the classification of altered levels of consciousness
 Enlist the causes of unconsciousness
 explain the pathophysiology of unconsciousness
 enlist the clinical manifestations of unconsciousness
 explain nursing management of patient with unconsciousness
 list out the complications of patient with unconsciousness
SR. TIME SPECIFIC CONTENT TEACHING LEARNING A.V EVALUATION
NO OBJECTIVES ACTIVITY ACTIVITY AIDS

INTRODUCTION :
01 Introduction
about CONSCIOUSNESS
unconsciousness A state of awareness of yourself and your
surroundings.
Ability to perceive sensory stimuli and respond
appropriately to them.

02. DEFINATION :
Define
UNCONSCIOUSNESS:
unconsciousness
 Abnormal state - client is unarousable and
Lecture Listening Define
unresponsive.
cum unconsciousne
 Coma is a deepest state of
discussion ss
unconsciousness.
 Unconsciousness is a symptom rather than
a disease. Degrees of unconsciousness that
vary in length and severity:
 Brief – fainting
 Prolonged – deep coma

03. What are the

List out the altered levels of
classification of Listening consciousness?
altered levels of CLASSIFICATION OF ALTERED LEVELS OF Lecture
consciousness CONSCIOUSNESS cum
discussion
1. Confusional States
2. Delirium
3. Obtundation
4. Stupor
5. Coma

1. CONFUSIONAL STATES :
People who do not respond quickly with
information about their name, location, and
the time are considered "confused". A
confused person may be bewildered,
disoriented, and have difficulty following
instructions. The person may have slow
thinking and possible memory loss. This
could be caused by sleep deprivation,
malnutrition, allergies, environmental
pollution, drugs (prescription and non-
prescription), and infection.

2. DELIRIUM: person may be restless or

agitated and exhibit a marked deficit in
attention.

3. OBTUNDATION: a person has a decreased

interest in their surroundings, slowed
responses, and sleepiness.

4. STUPOR: only respond by grimacing or

drawing away from painful stimuli.
 5. COMA • State in which a patient is totally
unaware of both self and external
surroundings, and unable to respond
meaningfully to external stimuli touch,
pain, light etc. Do not have sleep-wake
cycles. • Coma usually lasts a few days to a
few weeks. After this time, some patients
gradually come out of the coma, some
progress to a vegetative state, and some
die.

04. 6. PERSISTENT VEGETATIVE STATE

• Can result from diffuse injury to the Lecture Listening
Enlist the cerebral hemispheres of the brain without cum
causes of damage to the cerebellum and brainstem. discussion
unconsciousn • Opens eyes spontaneously
ess • Does not follow commands
• No intentional movements
• Demonstrate sleep -wake cycle

CAUSES OF UNCONSCIOUSNESS.

STRUCTURAL OR SURGICAL UNCONSCIOUSNES

Trauma
 Epidural / Subdural hematoma
 Brain contusion
  Hydrocephalus
 Stroke
 Tumor

METABOLIC OR MEDICAL UNCONSCIOUSNESS

 Infection
Explain the
 Meningitis
pathophysiolog
05.  Encephalitis
Explain the Lecture Listening y of
 Hypo/hyperglycemia
pathophysiolog  Heptic encephalopathy cum unconsciousne
y of discussion ss ?
 Hyponatremia
unconsciousnes  Drug /alcohol overdose
s  Poisoning.

PATHOPHYSIOLOGY
Damage to the brain and skull

Inflammation edema and haemorrhage

Increased ICP
06. enlist the
Diffused damage to the cerebral tissues
Listening clinical
Explaining manifestatio
Enlist the Blocks the signal to the RAS (Reticular activating ns of
clinical system) unconsciousn
manifestatio ess?
ns of
unconsciousn UNCONSCIOUSNESS
ess

 CLINICAL MANIFESTATION
 The person will be unresponsive (does not
respond to activity, touch, sound, or other
stimulation)

An unconscious person:
 Is unaware of his surroundings and does
not respond to sound
07.  Makes no purposeful movements Listening
 Does not respond to questions or to touch Lecture
 Confusion cum explain
explain  Drowsiness discussion nursing
nursing  Inability to speak or move parts of his or
her body
management
management  Loss of bowel or bladder control of patient
of patient (incontinence) with
with  Respiratory changes unconsciousn
 Abnormal pupil reactions.
unconsciousn ess?
ess

 NURSING MANAGEMENT
GOALS OF NURSING CARE
• Maintain adequate cerebral perfusion
• Remain normothermic
• Be free from pain, discomfort, and
infection
• Attain maximal cognitive, motor and
sensory function

ASSESSMENT :
Nurses frequently need to monitor the
conscious level as impairments may
complicate the existing condition and may
 cause complications and further
deterioration.

GLASGOW COMA SCALE.

 The Glasgow Coma Scale is a neurological

scale – Gives a reliable, objective record of
the level of consciousness (LOC) of a
person, for initial as well as continuing
O8. assessment.

Listening
Lecture
 The nurse observes and describes three cum
aspects of the patients behavior: discussion
1. Eye opening
list out the 2. Verbal response
complication 3. Motor response.
s of patient
with
Interpretation of Glasgow Coma Scale.
unconsciousn
 Highest score is 15/15 – Good
ess
orientation
 Lowest score is 3/15 - Deep coma.
Considered brain dead if client dependant
on a ventilator
GCS ≤ 8 – Severe brain injury
GCS 9 – 12 - Moderate brain injury
GCS ≥ 13 – Mild brain injury

COMPLICATION
 Head –lice/pressure sore

 Eye – corneal ulcers

 Mouth – parotitis, cracked lips, dry

lips

 Lungs – pneumonia

 Malnutrition

 Foot drop

 Wrist drop

 Pressure ulcers

 Joint contractures

 Muscle wasting
  Dehydration

 Urinary tract infections

CONCLUSION
• An unconscious patient fully depends on us for
his recovery as such it is our responsibility to
always think critically before intervening. • The
more the knowledge we have the greater the
difference we can make to life of unconscious
patients.
 BIBLIOGRAPHY
Jyoti kathwal textbook of nursing foundation for BSc nursing students’ 1 ST edition vision health sciences publishers
2021

Nisha clement principles and practice of nursing I second edition emmess medical publishers 2018

Page No. 159- 160

D. Elakkuvana bhaskara raj textbook of nursing foundation first edition emmess medical publishers 2021

Page no: 120 - 121