lethargic vs somnolent vs obtunded

Hi, Im Nurse Mo and I love mentoring nursing students! Between these two extremes are several altered levels of consciousness. [11] Mass lesions that occur above the tentorium cerebelli normally do not significantly alter the level of consciousness unless they are very large or affect both cerebral hemispheres.[9]. Characterizing the level of consciousness helps medical specialists to communicate about a patient's overall condition. (Medicine) An abnormal state of drowsiness, as caused by disease or drugs. lessons in math, English, science, history, and more. A concussion, which is a mild traumatic brain injury (MTBI) may result in decreased LOC. World J Emerg Med. My last pt. Somnolence vs Lethargy - What's the difference? | WikiDiff As with any altered LOC, lethargy has many potential causes, including anemia, an underactive thyroid and cancer. Disoriented, restless, hallucinations, sometimes delusions. I described her in my assessment as "obtunded". A lethargic patient will be sleepy but easy to arouse with verbal commands or light touch. Lethargynoun A state of extreme torpor or apathy, especially with lack of emotion or interest; loosely, sluggishness, laziness. What are Rhonchi? Stuporous you are very difficult to arouse and when you are aroused it is slurred garbled nonsense then you are out again. World J Emerg Med. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3614410 A state of extreme torpor or apathy . Several systems have been developed to standardize these classifications. [1] [2] Those who are not able to be aroused from a sleep-like state are said to be stuporous. Acute Febrile Illness Symptoms & Treatment | What is Febrile Illness? Delirium can result from everything from intoxication to surgery, especially in elderly patients. obtunded!) Hyperalert patients can be verbally and physically threatening, restless, and/or aggressive. 2014;7(2):124-127. Levels of Consciousness | NURSING.com Podcast [12] Reflexes, such as the cough and gag reflexes, are also means of judging LOC. And worse than this is a coma, which is a state of extreme unresponsiveness, one where the individual has no voluntary movement or behavior, no response to external stimuli (including pain), and one where normal reflexes may no longer be present. A stuporous patient refers to someone with a decreased level of consciousness. When documenting your patients level of consciousness, youll notice you have a LOT of options to choose from. Somnolence noun. She is now in a STUPOR. Enjoy! Obtunded: difficult to arouse. I think being in an obtuned state it is more likely similar to being in a state of drowsiness. [9] Exposure to drugs (e.g. But when outside agencies come into contact with the brain stem, altered levels of consciousness may be unavoidable 3. The obtunded patient is at a higher level of severity and will need repeated stimuli to awaken. Stupor can be caused by stroke, infection, organ failure, and toxins. DD declares that he has no competing interests. TC has worked as a paid speaker for GlaxoSmithKline and Pfizer in 2008 and 2009. James Lacy, MLS, is a fact-checker and researcher. You ask your patient where she is right now and she answers in my living room. At this time, your patient is ALERT and CONFUSED. Often, an altered LOC can deteriorate rapidly from one stage to the next. Injury. Am J Emerg Med. Clin Pediatr Emerg Med. Sometimes impaired consciousness is reversible, while other times it is not. She will follow simple one-step commands, but when you ask her to do more than one thing at a time, she does not always follow through. Somnolent adjective (dated) Causing literal or figurative sleepiness; soporific. According to the Merck online medical library, the term "obtunded," a form of obtundation, is an imprecise way to describe someone whose alertness or consciousness is moderately reduced 3. Somnolent: sleepy, responding to stimuli only with incoherent mumbles or disorganised movements. If we have a patient who is awake and alert for the 0700 assessment, but becomes lethargic or somnolent as the day progresses, this tells us that something is most definitely NOT RIGHT! If you tell us that the pt withdraws an extremity with painful stimuli, then we're all pretty much on the same page. http://www.ncbi.nlm.nih.gov/pubmed/25215076?tool=bestpractice.com, Another observational study reported that over half of adults ages over 65 years with AMS had delirium. obtunded: mentally dulled. It can be accompanied by depression, decreased motivation, or apathy. Prolonged unconsciousness is understood to be a sign of a medical emergency. We will try to find the right answer to this particular crossword clue. [9] A decreased LOC can also result from a combination of factors. Is lethargic or somnolent worse? Delirium is marked by confusion and being disoriented to the surroundings. Verbal, motor, and eye-opening responses to stimuli are measured, scored, and added into a final score on a scale of 315, with a lower score being a more decreased level of consciousness. Stupor is a decreased level of consciousness in which a patient requires vigorous physical stimuli to awaken. For example, I had a patient recently who was stuporous upon arrival to the ICU, but quickly became unresponsive, requiring immediate intervention in order to keep the patient safe. Pertaining to, affected with, or resembling, lethargy; morbidly drowsy; dull; heavy. producing lethargy: The lethargic heat and humidity of the day made me want to do nothing but nap. It has come into almost universal use for assessing people with brain injury,[2] or an altered level of consciousness. At Healthfully, we strive to deliver objective content that is accurate and up-to-date. Med Care. Increases in intracranial pressure (the pressure within the skull) can also cause altered LOC. Clin Geriatr Med. to obtund is to dull or blunt. BMJ. The main difference between lethargic and obtunded sleep is that Lethargic sleep is typically associated with a better quality of life, while obtunded sleep can lead to health problems. Pulse Deficit Causes & Calculation | What is Pulse Deficit? It can involve hyper-alertness as well as hallucinations. Comatose vs. Obtunded - What's the difference? | Ask Difference Lethargy noun. By Angela Morrow, RN Stupor is a deep level of impaired consciousness where individuals only briefly regain consciousness after repetitive stimulation. With over 2,000+ clear, concise, and visual lessons, there is something for you! http://www.medterms.com/script/main/art.asp?articlekey=4614. At this point she is UNRESPONSIVE or COMATOSE. LOC is an abbreviation describing patient awareness, alertness, and wakefulness. Enrolling in a course lets you earn progress by passing quizzes and exams. (pathology) A condition characterized by extreme fatigue or drowsiness, or prolonged sleep patterns. Syncope is a brief loss of consciousness that means the same as fainting or passing out. Clinical Methods: The History, Physical, and Laboratory Examinations. While I would agree with you, it's probably better to stick to more objective stuff, like GCS as Gwenith suggests. Levels of Consciousness Flashcards | Quizlet Being a successful nursing student is more than just study tips and test strategies. Obtunded, you are very difficult to arouse, but when you do arouse you talk clearly (even if only for 10 secs) and then you're out again. Fainting is more formally called syncope, and as you probably know, it is a brief loss of consciousness. Differential effects of the Glasgow Coma Scale Score and its components: An analysis of 54,069 patients with traumatic brain injury. 3rd edition. [12] Stroke and intracranial hemorrhage are other causes. 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Has 3 years experience. Perhaps you know of someone who has fainted, for any number of reasons. In the field of, Disoriented; impaired thinking and responses, People who do not respond quickly with information about their name, location, and the time are considered "obtuse" or ", Disoriented; restlessness, hallucinations, sometimes delusions, Some scales have "delirious" below this level, in which a person may be restless or agitated and exhibit a marked deficit in, Decreased alertness; slowed psychomotor responses, Sleep-like state (not unconscious); little/no spontaneous activity, People with an even lower level of consciousness, stupor, only respond by, Cannot be aroused; no response to stimuli, Comatose people do not even make this response to stimuli, have no, This page was last edited on 20 April 2023, at 02:07. They will awaken for a brief moment and then quickly fall back into a sedated and decreased level of consciousness. Additionally, no content on this website is intended to be a substitute for professional medical advice, diagnosis or treatment. However, more frequently patients exhibit altered levels of consciousness plus cognition: for example, with delirium, a relatively common and sometimes fatal cause of AMS. A urine drug screen may be sent. from the latin obtundere, to blunt. (There is an old thread on this exact topic of lethargic vs. Differences Between Obtunded and Stupor | Healthfully Xiao HY, Wang YX, Xu TD, et al. [3] A deficit in the level of consciousness suggests that both of the cerebral hemispheres or the reticular activating system have been injured. Definitely more severe than this is stupor, a deep level of impaired consciousness where only vigorous repeated stimuli arise the individual for a brief moment. The AVPU scale is another means of measuring LOC: people are assessed to determine whether they are alert, responsive to verbal stimuli, responsive to painful stimuli, or unresponsive. For example, patients with meningitis may have impaired consciousness (i.e., altered sensorium, decreased attentiveness) with intact cognition, whereas patients with dementia may have a normal level of consciousness with impaired cognition. Annualized. Sometimes, you may start with a mild state and rapidly progress through to a higher stage. 6,681 Posts. a person may be obtunded due to head trauma. Dr Gary Blanchard would like to gratefully acknowledge Dr David Dosa, a previous contributor to this topic. Confusion can come from drug abuse, a fever or even sleep deprivation, among other reasons. New Orleans Rapper Killed 2021, Articles L