Nursing Case Presentation on Metabolic Encephalopathy
Introduction
Metabolic encephalopathy is a diffuse cerebral dysfunction caused by systemic metabolic
derangements. It commonly results from hepatic failure, renal failure, electrolyte imbalance,
hypoglycemia, sepsis, or other metabolic causes. It presents with varying degrees of altered
mental status, ranging from confusion to coma.
Patient Profile
Name: Mr./Ms. X
Age: ___ years
Sex: Male/Female
IP No: ______
Date of Admission: ______
Occupation: ______
Religion: ______
Marital Status: ______
Chief Complaints
- Altered sensorium since ___ hours/days
- Confusion and disorientation
- Drowsiness/irritability/lethargy
- Associated symptoms: nausea, vomiting, decreased oral intake, fever, etc.
History of Present Illness
The patient was apparently well ___ days ago when he/she developed altered sensorium,
confusion, and drowsiness. Symptoms progressed gradually/rapidly. There was no history
of head trauma, seizures, or focal neurological deficit. Associated history includes [vomiting,
jaundice, decreased urine output, fever, etc. depending on case].
Past History
- Known case of Diabetes Mellitus / Hypertension / Chronic Kidney Disease / Liver Disease
(specify)
- No history of epilepsy or psychiatric illness
- No history of recent head injury
Family History
- No similar illness in the family
- No history of hereditary metabolic disorders
Personal History
- Appetite: Normal/Reduced
- Sleep: Disturbed due to illness
- Bowel & Bladder habits: Normal/Altered
- Habits: Smoking/Alcohol/Other substance use
General Examination
- Patient is drowsy/disoriented
- Vital signs: Temperature __, Pulse __, BP __, RR __, SpO2 __
- No pallor/icterus/cyanosis/edema/lymphadenopathy
Systemic Examination
CNS: Altered mental status, GCS ___/15, no focal deficit
RS: Clear/Crepitations
CVS: S1, S2 heard, no murmurs
PA: Soft/Distended/Tender (depending on case findings)
Investigations
- CBC, RFT, LFT, Electrolytes
- Blood sugar
- ABG analysis
- CT/MRI brain if indicated
Nursing Diagnosis
1. Altered thought process related to metabolic imbalance
2. Risk for injury related to altered sensorium
3. Self-care deficit related to decreased level of consciousness
4. Risk for aspiration related to impaired swallowing reflex
Nursing Interventions
- Maintain airway, breathing, and circulation
- Monitor vital signs and neurological status regularly
- Maintain fluid and electrolyte balance
- Ensure patient safety (side rails, restraints if needed)
- Assist in daily activities and personal hygiene
- Provide a calm and quiet environment
- Administer medications as prescribed
- Educate family members regarding condition and care
Conclusion
Metabolic encephalopathy is a medical emergency requiring prompt identification of
underlying causes and supportive management. Nursing care plays a vital role in
monitoring, preventing complications, and supporting recovery.
