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Written By nursingstikes on Monday, October 22, 2012 | 7:03 PM

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 Trouble Circulation [of] center blood
 System center nerve trauma
 Comma [is] situation go down heaviest awareness, where patient [do] not react again to pain in bone stimulus. Comma happened if/when there are trouble/ damage [at] awareness center [in] midbrain and/ or talamus.
 A. Disease intracranial a. Formation center nerve trauma b. trouble Circulation [of] brain blood c. Formation center nerve infection d. Formation center nerve tumor e. Attack- attack, epilepsy and spastic f. Degenerative center nerve formation disease g. High [of] intracranial pressure by various cause
 B. Disease ekstrakranial a. Vascular – syok, difficult [of] acute heart, hipertensi,hipotensi b. Metabolik – hepatic uremi diabetic,hipoglikemi, hiperglikemi, coma asidosis, hipoksi, electrolyte imbalance c. Poisoned – alcohol, barbiturate,narkotik, CO, anaesthetize otherly. d. Systematical infection [of] weight – pneumonia, malaria, typhoid e. Others – hipertermi, hipotermi, electrics syok, anafilatik syok
 Aloanamnesis have to be taken accurately because important to determine cause referring to effort medication [of] kausal.
 Physical examination cover
1. Awareness storey; level
2. Fungsivital a. Temperature Body - Go up - systematical infection, termoregulator trouble, hyperpyrexia heat ( accompanied [by] dry husk - Go down- poisoned [of] barbiturate, failure [of] perifer sirkulasi, miksedema b. respiration - Tardy - poisoned [of] morphine, poisoned [of] barbiturat, hipotiroid - In & quickly - pneumonia, mellitus diabetis, uremi, intracranial disease - Cheyne-Stokes - high [of] intracranial pressure, damage [of] brain bar c. pulse - Tardy- hypertension block heart, high [of] intracranial pressure - Quickly- ektopik heart rhythm, trouble circulation [of] brain blood d. Blood pressure - High - circulation [of] brain, hypertension ensefalopati. - Low- poisoned [of] alcohol, poisoned [of] barbiturate, heart infark, septikemi, Addison disease
3. Husk - Sianosis - Bright red - poisoned [of] CO - Bruise- trauma - Bloated - face hiperemi and eye, teleangiektasi - poisoned [of] alcohol - Pale- blood - Many sweat- hipoglikemi, syok - Dry – diabetic asidosis, uremi - Downhill Turgor - dehydration
4. Respiration aroma - Alcohol - Acetone/ rotten fruits - diabetikum comma - Ammonia/ urin- uremi - Rotten - hepatikum comma
5. Nerve formation - Tes stimulate pain in bone [in] supraorbital area, sterna, inner [of] thigh or arm - If/When natural neck fleksi motion [of] prisoner - brain membrane iritasi - If/When entire/all natural neck motion [of] prisoner - [common/ public] rigititas, disparity [of] servikalis spina - And Hemiparese disparity [of] disparity [of] other content
6. Other inspection to look for cause, figured in disease and complikasi
7. figured in inspection  - blood - routine, ureum, blood sugar, liver function, culture - urin - protein, glucose, acetone, cell, culture.
 - lumbal punksi - pressure, cell, glucose, protein
 - radiologik - skull bone; angiografi

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