This document provides information on caring for an unconscious patient. It discusses the causes of unconsciousness including trauma, tumors, strokes, infections, and drug overdoses. Signs of unconsciousness include being unresponsive, unaware of surroundings, and not responding to stimuli. General nursing considerations for unconscious patients include maintaining airway and breathing, providing nutrition through gavage or IV fluids, regular skin care, elimination, positioning, exercise, and pressure sore prevention.

1. VIDYAKIRANA GROUP OF INSTITUTION
SUBJECT- NURSING FOUNDATION
TOPIC- CARE OF UNCOUNSCIOUS PATIENT
PRESSENTED BY – MRS. SULEKHA DESHMUKH

2. INTRODUCTION
• CONSCIOUSNESS- a state of awareness of yourself
and your surroundings
• Ability to perceive sensory stimuli and respond
appropriately to them.

3. • UNCONSCIOUSNESS- in the state of not being
awake and not aware of things around you,
especially as the result of a head injury

4. Cause of unconsciousness
• Surgical unconsciousness ------
• Trauma [ a state of great shock or sadness]
• Epidural hematoma [ blood occurs between the dura
mater and the skull ]
• Hydrocephalus [ water on the brain]
• Stroke [interruption of blood supply]
• Tumor

5. Medical unconsciousness----
• poisoning
• Infection
• Meningitis
• Encephalitis
• Hypo/ hyperglycemia
• Hyponatremia[ maintain a balance of body fluid, muscles
and nerves]
• Drug / alcohol overdose

6. Sign and symptoms of unconscious patient
• The person will be unresponsive [ dose not respond
to activity, touch, sound, or other stimulation
• Unaware of his/ her surrounding and dose not
respond to sound
• No movement
• Dose not respond to question or to touch
• Drowsiness [ a state of being sleep ]

7. • Inability to speak or move parts of his /her body
• Loss of bowel or bladder control
• Stupor

8. General nursing consideration
• Always assume that the patient can hear, even
though he makes no response
• Always address the patient by name and tell him
what you are going to do
• Refrain [ to stop yourself doing something] from any
conversation about the patients condition while in
the patient’s presence.

9. Conn….
• Regularly observe and record the patient’s vital signs
and level of consciousness
• 1- always take a rectal temperature
• 2-Report change in vital signs to the professional
nurse
• 3- note change in response to stimuli

10. • 4- Note the return of protective reflexes such as
blinking the eyelids or swallowing saliva
• 5- keep the patient room at a comfortable
temperature, adjust the room temperature if
patient’s skin is too warm or too cool.

11. Care of the patient
• A - AIRWAY AND BREATHING- maintain a patent
airway by proper positioning of the patient.
Whenever possible, position the patient on his/her
side with the chin extended , this prevent the tongue
from obstructing the airway
• This is lateral recumbent position is often referred to
as the ‘coma position’

12. • B – suction the mouth, pharynx and trachea as often
as necessary to prevent aspiration of secretion
• C – Reposition the patient from side to side to
prevent pooling[collection] of mucous aspiration of
secretion
• D- administer oxygen as ordered

13. Nutritional
Need

14. • A patient who is unconscious is normally feed by
gavage
• Always observe the patient care fully when
administering anything by gavage
• Do not leave the patient unattended while gavage
feeding
• Keep accurate records of all intake [ feeding formula,

15. Conn…
Water, liquid medications]
• When gavage feeding an unconscious patient. It is
best to place the patient in a sitting position [
fowlers or semi – fowlers ] and support with pillows.
• fluids are maintained by intra venous therapy
• Keep accurate records of intra venous intake and
urine output

16. Conn..
• Observe the patient for signs of dehydration or fluid
overload. [ is a condition where you have too much
fluid volume in your body like blood and water,
people with heart and kidney condition often
experience fluid overload[ hypervolemia ]

17. Skin care

18. • The unconscious patient should be given a complete
bath every other day, this prevents drying of the
skin . The patient’s face and perineal area should be
bathed daily.
• The skin should be lubricated with moisturizing
lotion after bathing.
• The nail should be kept short.

19. • Provide oral hygiene at least twice per shift include
the tongue, all tooth surfaces and all soft tissue area
• Apply petroleum to the lips to prevent dryness.
• Keep the nostrils free of secretion.
• Check the eyes frequently for signs of irritation or
infection, neglect can result in permanent damage to
the cornea.

20. • Use only cleansing solutions and eye drops ordered
by the physician.
• If the patient incontinent, the perineal area must be
washed and dried thoroughly after each incident.
• Change the bed linen if dame or soiled.
• Observe the skin for evidence of skin breakdown.
• Gently massage the skin to stimulate circulation.

21. ELIMINATION
–
• excreting waste
product from the
body

22. • The bowel should be evacuated regularly to prevent
impaction of stool.
• Keep accurate record of bowel movements. Note
time, amount, color, and consistency.
• A liquid stool softener may be ordered by the
physician to prevent constipation or impaction. It is
generally administered once per day

23. • If enemas are ordered, use proper technique to
ensure effective administration.
• The bladder should be emptied regularly to prevent
infection or stone formation
• Adequate fluid should be given to prevent
dehydration

24. • Keep accurate intake and output records
• Report low urine output to professional nurse.
• Provide catheter care at least once per shift to
prevent infection in catheterized patients.

25. • POSITIONINING -- when positioning the unconscious
patient pay particular attention to maintain proper
body alignment . The unconscious patient cannot tell
you that he is uncomfortable or is experiencing
pressure on a body part.
• When turning the patient maintain alignment and do
not allow the arms to be caught under the torso.

26. • Change the patient position every two hours this
decrease the likelihood of complication such as
pressure ulcer .
• Utilize a food board at the end of the bed to decease
the possibility of food drop.

27. • When joints are not exercised in their full range of
motion each day, the muscles will gradually shrink.
Passive exercise must be provided for the
unconscious patient to prevent contraction.
• Exercise with a range of motion are performed under
the direction of the physical therapist
• Nursing personnel must be proficient in ROM
exercise

28. • Physical therapy personnel will not always be
available
• It is a nursing care responsibility to maintain the
patient’s range of motion.

29. CARE OF PRESSURE SORES
• Utilize a protective mattress such as a flotation
mattress[encourage blood circulation, help relieve
backaches] alternating pressure mattress[ relieve
from pressure and improve blood flow] or eggcrate
mattress[ provide additional support on spine, hip
and shoulder when lying down].
• Change the patient position at least every two hours.

30. flotation
mattress
eggcrate
mattress
alternating pressure
mattress

31. Protect the patient from injury
• Keep side rails up.
• Pad the rails with pillow or folded blankets
• Keep sharp objective out of the bed
• Use draw sheets for easier turning
• Keep suction equipment available at the bedside for
emergencies

32. • RESTRAINS – use restrains only with physician’s order
• Use mitten restrains to prevent the patient from
pulling at catheter, iv set and his hair .
• Take precaution to prevent restrain from becoming
restricting do not cut off circulation , do not irritate
the skin.