Which neurological assessment is particularly important when assessing the patient who is comatose?
a. graphesthesia, stereognosis, and two-point discrimination
b. doll's eyes, Babinski reflex, and corneal reflex
c. proprioceptive sensation and cerebellar function
d. superficial pain and light touch
B
When assessing the comatose patient, family and prior health care records can provide valuable information. Omit components of the assessment that require volition and patient cooperation. Remember to assess neurological status thoroughly. Consider assessing doll's eyes, corneal reflex, Babinski's reflex, clonus, and superficial and deep pain response. Options "a," "c," and "d" are aspects of a sensory assessment and require an alert patient who can cooperate. Graphesthesia, stereognosis, and two-point discrimination are assessed as part of the cortical sensations (those that require cerebral integrative and discriminative abilities). Proprioceptive sensations include deep sensations, with sensory receptors in the muscles, joints, tendons, and ligaments. Superficial pain, light touch, and temperature are exteroceptive sensations.
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