Neuro: Level of Consciousness (LOC) – Answers

1) What do you think it means to have an altered Level of Consciousness (LOC), and what are some possible causes?

An altered LOC is a change in awareness. This change in LOC could range from mild (exhaustion because you’ve been awake for 24-hours straight…but a good night sleep will set you right!) to the more serious (coma). LOC could have a large number of causes. These include:

·        trauma (head injury or shock)

·        electrolyte imbalances (hypo/hypernatremia, etc)

·        CerebroVascular accident (CVA, stroke)

·        Ingestion of drugs or alcohol

·        Hypoxia (not getting enough O2 into the body)

This list is not all-inclusive, and you might have been able to think of a few more that I didn’t mention.


2) What are some common terms that nurses and other medical personnel use to describe various levels of consciousness, and describe what kind of pt they would be used for. For example, I’ll do the first one.

  • Alert: Oriented to person, place, and time


Your turn now!

  • Coma: unarousable, may respond to stimuli but response is non-purposeful.
  • Confusion: Disoriented to person, place and/or time; unable to think clearly

·        Lethargy: This word is often misused to mean “less active than usual.” Actually, when you think lethargy, you should think “rag doll.” But they are oriented x3.

·        Obtunded: Can be aroused and will respond with a couple words, but then goes right back to sleep.

·        Stupor: Difficult to arouse. When you do arouse the pt, they only respond minimally with grunts or groans, maybe opening their eyes.



3) Tell me about the Glasgow Coma Scale. You’ll definitely see a question about this at some point.

  • Uses 3 categories of responses to measure the pt’s status:
    • Eyes Open (scale of 1-4)
    • Best Verbal Response (scale of 1-5)
    • Best Motor Response (scale of 1-6)
  • The max possible score is 15, the lowest possible score is 3. You do not want a 3.
  • When assessing a pt using the Glasgow Coma Scale, you assign a score depend on their level of response in that category. The better the response, the higher the score. Someone in a coma would get a 3, and someone walking and talking would get a 15.