Assessment of Attitude, Level of Consciousness, and Orientation (Nursing)

by Brenda Marshall, EdD, MSN, RN

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    00:01 We also want to be looking at their attitude as well as their level of consciousness.

    00:06 So what about their attitude? We are going to observe an attitude.

    00:13 Do they have an open attitude? Are they willing to talk to us? Are they sitting down and sort of, "Hey, how you doing?" Yeah, so one of the questions. I've been here before.

    00:26 Are they quite secretive? I really rather not speak louder than this. If it's okay with you.

    00:37 People are listening.

    00:39 They're giving you a secret of attitude? Are they being cooperative? When you're asking them to do things, are they saying, "Sure, I can do that?" Are they being suspicious? Hmm.

    00:56 Are they apathetic? Do they seem not to care at all about what's going on? Or are they kind of giving you the evasive moves? So you ask them a question? It's like, "I don't know about that.

    01:10 But and they'll start talking about something else.

    01:15 Are they able to focus? Is their attitude focused? I'm here for this reason. I really want this to happen.

    01:22 This is where we're going to be moving.

    01:24 This is an attitude.

    01:27 We know how to assess level of consciousness.

    01:30 We do it all the time.

    01:32 On med surg floors, we do it in the emergency room, we do it post operatively.

    01:38 Is the person that we're looking at, are they alert? Are they answering us? Are they drowsy? Are they vigilant? Are they looking around? Are they, is that level of consciousness fluctuating? Are they alert for a little while and then suddenly, they start getting drowsy? And then they're alert again? Are they confused? Is the person unable to gather their thoughts? Are they stupurous? Are they unable to respond to us? Is the person comatose? When would hope not.

    02:15 But we do have some patients who appear to be almost comatosed, Their level of consciousness seems to be as though they are not even in our same reality not moving.

    02:29 We have to assess.

    02:30 We want to look for changes and level of consciousness for a number of reason.

    02:35 One, because it might indicate where they are, psychologically, but also have they take in some kind of drugs that have changed their level of consciousness? As we are assessing them, are they changing the level of consciousness? Are we facing somebody who is becoming delirious, these are extremely important.

    03:18 We also want to know their orientation.

    03:22 We want to know if they're oriented to person.

    03:24 We will say to them, what's your name? Who are you? Do you know where you are right now? We want to know that they are oriented to place.

    03:34 We want to know that they're oriented to time.

    03:36 Do you know what year it is? These are extremely important.

    03:42 We also want to know however, are they oriented to current events? And this is a difficult one.

    03:49 We might want to ask them who the president is.

    03:52 But make sure it's not a year where there's a change in presidents because they might be confused to that.

    03:59 You might be able to ask them other questions that perhaps are easier.

    04:04 Now, who is the governor of your state, if the governor has been the governor for a while? Current events are also quite different for those people who have beginning dementia.

    04:16 And they may be going back to events from way past.

    04:23 We also want to find out if they have insight.

    04:27 One of the things that really identify psychiatric patients who are in need of help is their lack of insight.

    04:37 You say, "Why are you here?" And they say, "I haven't got a clue.

    04:43 There is nothing wrong with me.

    04:46 But my family thinks I should be here and I just want to humor them."

    About the Lecture

    The lecture Assessment of Attitude, Level of Consciousness, and Orientation (Nursing) by Brenda Marshall, EdD, MSN, RN is from the course Psychiatric Assessment (Nursing).

    Included Quiz Questions

    1. Cooperative
    2. Suspicious
    3. Open
    4. Alert
    5. Drowsy
    1. "What is your name?"
    2. "What is the date today?"
    3. "Can you tell me where you are right now?"
    4. "What medications are you taking?"
    5. "Can you spell the word "world" backward?"

    Author of lecture Assessment of Attitude, Level of Consciousness, and Orientation (Nursing)

     Brenda Marshall, EdD, MSN, RN

    Brenda Marshall, EdD, MSN, RN

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