Decrease in level of consciousness.. performing a neurological assessment on a client post right CVA

The nurse is performing a neurological assessment on a client post right CVA. Which finding, if observed by the nurse, would warrant immediate attention?

A- Decrease in level of consciousness.
B- Loss of bladder control.
C- Altered sensation to stimuli.
D- Emotional ability.

Answer: A: Decrease in level of consciousness

A further decrease in the level of consciousness would be indicative of a further progression of the CVA.

Decreased state of consciousness:
It is a state of diminished consciousness.
Comma is a state of decreased mental lucidity from which a patient cannot wake up. Prolonged coma is called a vegetative state.

Causes:
Many conditions can cause a decrease in mental lucidity, including:
- Chronic kidney disease.
- Extreme tiredness or lack of sleep.
- Hyperglycemia or hypoglycemia.
- High or low sodium concentration in the blood.
- Infection that is severe or compromises the brain.
- Liver failure.
- Thyroid disorders that cause low thyroid hormone levels or very high thyroid hormone levels.

Injury or brain disorders, such as:
- Alzheimer's dementia or disease.
- Head trauma.
- Seizures.
- Stroke.
- Infections that affect the brain such as meningitis or encephalitis.

Injury or accidents, such as:
- Diving accidents and imminent drowning.
- Insolation.
- Very low body temperature (hypothermia)

Heart or respiratory problems, such as:
- Abnormal heart rhythm.
- Lack of oxygen for any cause.
- Low blood pressure.
- Severe heart failure.
- Serious lung diseases.
- Very high blood pressure.

Toxins and drugs, such as:
- Alcohol consumption (drinking too much or damage due to prolonged alcohol consumption)
- Exposure to heavy metals, hydrocarbons or toxic gases.
- Exaggerated consumption of drugs such as opiates, narcotics, sedatives, and anxiolytics or anticonvulsants.
- Side effects of almost any medication, such as those used to treat seizures, depression, psychosis and other conditions.
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