Altered mental status (AMS) is a cognitive disorder, usually appearing in the elderly, that is defined as “a state of a change in which an individual’s normal waking consciousness is altered and his awareness of himself and his environment is impaired,” according to the Cornell University School of Nursing. AMS may be caused by or accompanied by other medical conditions such as pneumonia, dehydration, or cardiac arrest. The causes of AMS are classified as delirium, dementia or depression.

Nursing Diagnosis Altered Mental Status

1. Altered mental status (AMS) is a cognitive disorder, usually appearing in the elderly, that is defined as “a state of a change in which an individual’s normal waking consciousness is altered and his awareness of himself and his environment is impaired,” according to the Cornell University School of Nursing.

Altered mental status (AMS) is a cognitive disorder, usually appearing in the elderly, that is defined as “a state of a change in which an individual’s normal waking consciousness is altered and his awareness of himself and his environment is impaired,” according to the Cornell University School of Nursing.

Causes

There are many causes for AMS. Some of these are:

• Alcohol withdrawal syndrome
• Brain injury or trauma (including stroke)
• Diabetes mellitus or hyperglycemia (high blood sugar level)

2. AMS may be caused by or accompanied by other medical conditions such as pneumonia, dehydration, or cardiac arrest.

AMS may be caused by or accompanied by other medical conditions such as pneumonia, dehydration, or cardiac arrest. AMS is often found in the elderly.

The following nursing diagnoses are related to impaired mental status:

• Disturbed sleeping pattern (elderly)
• Delirium (elderly)

3. The causes of AMS are classified as delirium, dementia or depression.

Delirium is the sudden onset of confusion, memory loss, and alteration in consciousness. Delirium can be caused by a variety of medical conditions, but it is commonly associated with serious illnesses like heart disease, stroke and cancer.

Dementia is an irreversible decline in mental function that results in long-term losses in cognition and behavior. Dementia often occurs as a result of Alzheimer’s disease or other types of dementia such as vascular dementia (caused by strokes) or frontotemporal dementia (caused by brain tumors). Depression is a mood disorder characterized by feelings of sadness that interfere with daily life over an extended period of time.

4. The primary determining factor in diagnosing AMS is the presence of some symptoms that are new or worse than they have been before.

While the primary determining factor in diagnosing AMS is the presence of some symptoms that are new or worse than they have been before, there are also certain symptoms that would not be part of this diagnosis. These include:

• Nausea and vomiting: This can occur as a result of an infection or other stimuli, but it does not qualify for AMS. If you feel nauseous for more than 24 hours, your doctor may want to take a look at what might be causing this side effect.
• Urinary tract infections (UTIs): UTIs are caused by bacteria entering your urinary system and multiplying there; they’re typically easily diagnosed with a urine test and treated with antibiotics. While they may cause discomfort during treatment (especially when urinating), they will not meet criteria for AMS unless they also lead to other complications such as delirium, confusion or disorientation in addition to pain while urinating due to inflammation around the urethra leading up into bladder itself(this last symptom is called cystitis).

5. Diagnosis of AMS begins with asking the patient to describe their symptoms and current condition.

The first step in diagnosing AMS is to ask the patient to describe their symptoms and current condition. This information will help you determine the type of AMS, as well as any other conditions that may be present.

For example:

“Do you feel confused?”

“Can you tell me what happened before today?”

“How long have these symptoms been going on for?”

6. It’s important to rule out other possible causes for the patient’s altered mental status.

In addition to the nursing diagnoses listed above, other causes include:

• Dehydration. When your body doesn’t have enough fluids, you can develop confusion and related symptoms of delirium. If you’re elderly or have diabetes, you may be at risk for dehydration when your kidneys aren’t working as well.
• Medication. Certain drugs can cause altered mental status if they affect brain function (such as sedatives) or interfere with the way nerves send messages to one another (such as antihistamines). Sometimes a medication combined with another drug can lead to adverse effects that result in an altered state of consciousness.
• Infections. Viral infections like meningitis are common causes of altered mental status that require immediate medical attention for treatment and recovery from the infection itself so damage doesn’t occur inside the brain or spinal cord…

7. Because some medications can cause an altered mental state, it’s important to ask what medications the patient is taking.

It is important to ask what medications the patient is taking, since some medications can cause an altered mental state. Ask:

• What are you taking?
• Why are you taking it?
• How does it affect you (side effects/benefits)?

8. Patients are questioned about previous medical history that might indicate a pattern of similar experiences.

• Ask about previous episodes of altered mental status.
• Ask about a family history of altered mental status.
• Inquire about medications that the patient has taken recently or may be taking now, including over-the-counter drugs and herbal remedies.
• Ask if alcohol is used or abused by the patient, either alone or in combination with other substances (including prescription medications).
• Ask about other drug use, including street drugs and prescription medications obtained illegally.

Physical health concerns: * Fever (low-grade temperature for several days) * Fatigue/weakness/tiredness (particularly if accompanied by night sweats) * Weight loss/weight gain In addition to these physical signs and symptoms mentioned above, ask whether there have been any periods where your loved one seemed off balance while walking or moving around; did they seem confused as to where they were; did they talk more than usual? Mental health concerns: * Depression/anxiety problems Social history: Have there been any recent changes in social support system? Has someone died in your loved one’s life recently? How are their relationships with friends and family members at home? Sleep patterns: Are there any disruptions to this pattern (for example, difficulty falling asleep)?

9. Men with Alzheimer’s disease may respond better to testosterone replacement therapy than women with Alzheimer’s disease.

Men with Alzheimer’s disease may respond better to testosterone replacement therapy than women with Alzheimer’s disease.

Testosterone is a hormone that is produced in the testes. Testosterone replacement therapy is used to treat low testosterone levels. It should not be used for women because it can cause masculinization, which may be of concern if female breast cancer or uterine cancer is present.

Testosterone replacement therapy involves the use of patches, gels, pellets placed under the skin, or injections into muscles every two weeks or so.

10. Finding out what kind of treatment will be most effective in treating AMS can take quite a lot of detective work.

As you can see, there are a variety of possible causes for AMS, so it’s important to rule out other possible causes. Some medications can cause AMS, so it’s important to ask what medications the patient is taking.

Closing

The treatment for AMS will depend on the cause and severity.