PT ASSESSMENT - Topic 4

• NEUROLOGIC ASSESSMENT

  1. verbal response (5pts)
  2. Eye movement (4pts)
  3. Motor response (6pts)
• GCS

  stands for Glasgow Coma Scale
• VERBAL RESPONSE

  5- oriented

  4- confused

  3- inappropriate words

  2- incomprehensible sounds

  1- no response
• EYE MOVEMENT

  4- spontaneous

  3- reacts to speech

  2- reacts to pain

  1- no response
• MOTOR RESPONSE

  6- obeys command

  5- localizes pain

  4- withdraw from pain

  3 - abnormal flexion (decorticate)

  2- abnormal extension (decerebrate)

  1 - no response
• GCS SCORES

  13-15: NORMAL

  9-12: MODERATE COMA

  3-8: SEVERE COMA
• SODIUM (Na+)

  135 to 145 mEq/L

  <135 : HYPONATREMIA

  >145 : HYPERNATREMIA
• POTASSIUM (K+)

  3.5 to 4.5 mEq/L

  <3.5 : Hypokalemia

  >4.5 : Hyperkalemia
• CHLORIDE (Cl-)

  98 to 107 mEq/L

  <98 : HYPOCHLOREMIA

  > 107 : HYPERCHLOREMIA
• CALCIUM (Ca)

  8.6 to 10.5 mmol/dL

  <8.6 : HYPOCALCEMIA

  >10.5 : HYPERCALCEMIA
• BICARBONATE (HCO3)

  22 to 26mEq/L
• RBC

  4-6 million/mm3
• HEMOGLOBIN

  MALE : 14 to 18 g/dL

  FEMALE : 12 to 15g/dL

  GEN POP: 12 to 16 g/dL
• HEMATOCRIT

  Male: 40 to 54%

  Female: 35 to 49%
• WBC

  4,500 to 11,500/mm3
• PLATELETS

  150,000 to 400,000/ mm3
• HEMOGLOBIN: part of RBC, carries oxygen, red blood cells.

  HEMATOCRIT: percentage of blood that is RBC.
• POLYCYTEMIA

  INCREASED RBC
• ANEMIA

  DECREASED RBC
• Lowest possible GCS score:

  GCS 3
• HIGHEST POSSIBLE GCS SCORE:

  GCS 15
• HIGHEST POSSIBLE GCS SCORE FOR INTUBATED PATIENT:

  GCS 11