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Practical Nurse (LPN)
Fundamentals of Nursing
Assessments & Vital Signs
Level of Consciousness: Descriptive guide for Glasgow Coma Scale

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Level of Consciousness: Descriptive guide for Glasgow Coma Scale

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Level of Consciousness: Descriptive guide for Glasgow Coma Scale

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To assess a patient's neurological status requires a nurse to understand all elements of the levels of consciousness. It is very important to understand that, in nursing, a change in level of consciousness can be seemingly minimal. This can present as subtly as noting a new onset of behaviors that were not exhibited previously, like restlessness, anxiety, and confusion. These are all examples of a change in level of consciousness, which can alert the nurse to a change in condition that has, or is, occurring. This allows for quick intervention if necessary. Understanding the seven levels of consciousness is important for documentation and legal purposes in nursing. When patients are unable to communicate, such as in the case of brain trauma, there is a universal tool to gauge level of consciousness known as the Glasgow Coma Scale. This tool provides a reliable, objective method for recording the conscious state of a person for initial and subsequent assessments. A patient is assessed against the criteria of the scale, and the resulting points give a patient a score between 3 (indicating deep unconsciousness) and either 14 or 15 (indicating full consciousness and alertness). Both aid the nurse in assessing the neurological status of a patient.

Normal, attentive; oriented to self, place, and mind.


Impaired or slowed thinking; disoriented.


Disoriented, restless, clear deficit in attention; possible incidence of hallucinations and delusions.


Excessive drowsiness; little response to external stimuli.


Decreased alertness, slowed motor responses; sleepiness.


Conscious but sleep-like state associated with little or no activity; only responsiveness is in reaction to pain.


No response to stimuli, cannot be aroused; no gag reflex or pupil response to light.


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