Mental status change

Mental status changes may indicate impending respiratory failure. 

Evaluate for signs and symptoms of hepatic encephalopathy. Mental status changes may be subtle questioning family members or caregivers about confusion or personality changes may reveal mild hepatic encephalopathy even if the patient is unaware of the deficits. 

TBW depletion (often referred to as dehydration ) is typically a more gradual, chronic problem compared to ECF depletion. Because TBW depletion represents a loss of hypotonic fluid (proportionally more water is lost than sodium) from all body compartments, a primary disturbance of osmolality is usually seen. The signs and symptoms of TBW depletion include CNS disturbances (mental status changes, seizures, and coma), excessive thirst, dry mucous membranes, decreased skin turgor, elevated serum sodium, increased plasma osmolality, concentrated urine, and acute weight loss. Common causes of TBW depletion include insufficient oral intake, excessive insensible losses, diabetes insipidus, excessive osmotic diuresis, and impaired renal concentrating mechanisms. Long-term care residents are frequently admitted to the acute care hospital with TBW depletion secondary to lack of adequate oral intake, often with concurrent excessive insensible losses. 

Assess patients receiving systemic corticosteroids for mental status changes, fluid retention, increased blood glucose, muscle weakness, or development of new infections. 

Respiratory cough (productive or nonproductive), shortness of breath, difficulty breathing Nonrespiratory fever, fatigue, sweats, headache, myalgias, mental status changes... 

Nonrespiratory fever, fatigue, sweats, headache, myalgias, mental status changes... 

Patients with elevated intracranial pressure may have mental status changes. 

For corticosteroid use, serum glucose, insomnia, fluid retention, GI upset, mental status changes, signs and symptoms of infection daily... 

Mental status changes (most common) leads to loss of consciousness, irritability, confusion... 

Provide patient education regarding when to take medications, the importance of compliance, and promptly reporting symptoms of recurrence (e.g., mental status changes and seizures). 

Altretamine (hexamethyl- melamine) -alkylating agent -nausea and vomiting -bone marrow suppression -diarrhea, abdominal cramps -mucocutaneous effects (stomatitis, mucositis) -neuropathies -mental status changes... 

The onset of cardiopulmonary arrest may be characterized by symptoms of anxiety, mental status changes, or unconsciousness cold, clammy extremities dyspnea, shortness of breath, or no respiration chest pain diaphoresis, and nausea or vomiting. 

Fluid overload can result in pulmonary congestion and peripheral edema. Nonspecific symptoms may include fatigue, nocturia, hemoptysis, abdominal pain, anorexia, nausea, bloating, ascites, poor appetite, ascites, mental status changes, and weight gain. 

Mental status changes associated with volume depletion may range from subtle fluctuations in mood to agitation to unconsciousness. 

In the non-AIDS patient, the symptoms of cryptococcal meningitis are nonspecific. Headache, fever, nausea, vomiting, mental status changes, and neck stiffness are generally observed. In AIDS patients, fever and headache are common, but meningismus and photophobia are much less common than in non-AIDS patients. 

Elderly patients frequently do not experience specific urinary symptoms, but they will present with altered mental status, change in eating habits, or GI symptoms. 

Symptoms of MBC depend on the site of metastases, but may include bone pain, difficulty breathing, abdominal pain or enlargement, jaundice, and mental status changes. 

The combination of an SSRI with another 5-HT augmenting agent can lead to the serotonin syndrome, which is characterized by symptoms such as clonus, hyperthermia, and mental status changes. 

Withdrawal symptoms include mental status changes, tremors, elevated blood pressure, tachycardia, tremors, and severe agitation. BZs may be useful to control agitation. 

Symptoms Fever, headache, myalgias, arthralgias, back pain, sweats, chills, and generalized malaise. Additional signs or symptoms may include depression, mental status changes, sacroiliitis, and vertebral osteomyelitis however, fatalities tend to be uncommon. 

Discussion This was first adequately documented study of the exposure of military volunteers to BZ. More extended baselines were used, as well as scheduled observations at 1, 2, 3, 4, 5, 6, 10, 24, 48 and 72 hours after administration of the drug. Vital signs and neurological status were recorded at approximately the same intervals. The examining physician recorded mental status changes whenever they occurred. The data were less than optimal due to the infrequency of observations after 10 hours, as well as the brevity of written records of behavioral changes. 

Sinemet 10/100 Sinemet 25/100 Sinemet 25 0 Antiparkinsonian Tab Carbidopa 10 mg, levodopa 100 mg Tab Carbidopa 25 mg, levodopa 100 mg Tab Carbidopa 25 mg, levodopa 250 mg 1 tab tid-qid dyskinesia, nausea, mental status changes, paranoia, psychosis, depression. 

Because of sensory neuropathy, deep pain is often experienced by patients given vincristine. Through involvement of the glossopharyngeal nerve, throat pain may occur, as may deep pain of almost any other area of the body (31,32). Neuropathic changes are not always peripheral. Hallucinations and overall mental status changes, such as depression and/or psychosis, are also rarely reported (31,32). Another CNS effect is the syndrome of inappropriate antidiuretic hormone secretion, which is a well-characterized side effect of vincristine (31,32). 

Interferon beta-lb-. Injection site reaction (85%), headache (84%), flu-like symptoms (76%), fever (59%), pain (52%), asthenia (49%), myalgia (44%), sinusitis (36%), diarrhea, dizziness (35%), mental status changes (29%), constipation (24%), diaphoresis (23%), vomiting (21%)... 

Nephrotoxicity (characterized by increased serum creatinine level and decreased urine output), neurotoxicity (including tremor, headache, and mental status changes), and pleural effusion are common adverse reactions. 

Two different patterns of clonidine-induced cardiovascular complications have been described (Swanson et ah, 1995). One is characterized by decreased pulse and BP, often with associated EKG changes, fatigue, and sedation, and responds to a decrease in dosage. The other presents with tachycardia, tachypnea, with or without fever, anxiety, panic, and acute mental status changes, and is often associated with a missed dose or an abrupt taper. This pattern often responds to reinstituting the dosage and slowly tapering as necessary. 

The mainstay of medical treatment is fluid restriction, but this may not be appropriate in the surgical and critical care patient population. Severe (<120 mmol-L-l) or symptomatic hyponatraemia (mental status changes, seizure) requires more aggressive therapy to reduce cerebral oedema. Infusion of hypertonic saline to increase plasma sodium concentrations to 120-125 mmol L-1 alleviates symptoms. Adjunct therapy with demeclocycline (600 mg-day-1) may assist management in resistant SIADH. Demeclocycline is a tetracycline antibiotic which inhibits the actions of ADH at the renal tubules. 

The most serious complication of hyperthyroidism is thyroid storm (thyrotoxic crisis). This is an acute exacerbation of hyperthyroidism with marked tachycardia, fever, mental status changes and haemodynamic collapse. It is usually precipitated by acute illness, trauma, parturition or surgery, especially of the thyroid gland. The mortality rate is 20-30%, even with aggressive treatment, due to cardiac failure, arrhythmias or hyperthermia. 

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