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Altered Mental Status 

Altered Mental Status
Altered Mental Status
Acute Care Casebook

Cynthia Oliva


This case illustrates the diagnostic approach to evaluating an elderly person with altered mental status. It is important to maintain a broad differential of possible etiologies contributing to a decreased level of alertness. In this case, the patient suffers from hypercarbia due to hypoventilation. This patient is at increased risk of hypoventilation due to his history of chronic obstructive pulmonary disease and the administration of narcotic pain medication. Airway management is a top priority during the resuscitation of a patient suffering from hypercarbia. Methods of airway management include ensuring a patent airway, the administration of oxygen, initiating noninvasive positive pressure ventilation, and, if these measures fail, endotracheal intubation.

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