Should a nurse be concerned that upon arrival to the nursing unit the patient is lethargic?

Answer 1

It depends on the diagnosis of the patient and the medications they are taking and also consider the age. Looking at the diagnosis...is there a brain injury involved. Has the patient had head trauma? A stroke? Is the patient a diabetic? If so get a BS reading (hyperglycemia and hypoglycemia can be a cause. Is the patient been Dx with dementia? Suffering from ICP ( intracranial pressure) from an injury? Look at the age of the patient. A 90 year old may be more lethagic than a 32 year old. Medications: Always keep a nursing drug book in your pocket, or download it your phone. People respond differently to the same medications. Hydrocodone may make me lethargic and the next patient gets N/V, slow respirations and the third patient gets CNS stimulation. Ativan, Valium, pain pills or epilepsy medications (to name a few) can all cause drowsiness and even confusion. Look at your progress notes...what have other nurses noted lethargy in the chart. If you find nothing call the family and ask if they are "normally" this way. Then call the physician and inform him/her and chart that you have done so. In short, do your nursing assessment and use your nursing judgement. You would be advised to at minimum get a set of vitals before calling the doc. Remember it is your license so if your are unhappy with the physician's orders or actions notify your manager and go over the doctors head to get this addressed. Nurses are patient's advocates.