After a road traffic accident, a patient's motor score is 2 on GCS. It means?

Appeared in: JIPMER Nursing Officer - 2020

Explanation

A motor score of 2 on the Glasgow Coma Scale (GCS) indicates an extension response to a painful stimulus.
This type of posturing is known as decerebrate rigidity or decerebrate position.
It signifies severe damage to the brainstem, particularly at the level of the midbrain or upper pons.

Option B: This corresponds to a GCS motor score of 3, which is 'Abnormal Flexion'.
Option C: This describes two different scores. Abnormal flexion is a score of 3 (decorticate), and withdrawal from pain is a score of 4.
Option D: This corresponds to a GCS motor score of 5.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Interpretation of Glasgow Coma Scale (GCS) Motor Score in the correct sequence, documenting the action clearly, and monitoring for the expected response.
Accurate GCS scoring is a fundamental nursing skill in emergency and critical care settings for monitoring neurological status and detecting deterioration.
A decrease in the GCS motor score, for example from 3 to 2, is a critical finding that must be immediately reported to the physician as it indicates worsening brain injury.
Decerebrate posturing (Score 2) generally indicates more severe brain damage and a poorer prognosis than decorticate posturing (Score 3).

How to Approach the Question

First, identify the key information in the question: 'motor score is 2 on GCS'.
Recall the six levels of the GCS motor response scale.
Mentally associate each score with its specific response: 6-Obeys, 5-Localizes, 4-Withdraws, 3-Abnormal Flexion (Decorticate), 2-Extension (Decerebrate), 1-None.
Match the given score (2) to its corresponding response (Extension/Decerebrate).
Evaluate the options to find the one that matches 'Extension' or 'Decerebrate position'.

Concept Tested & Keywords

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E6 Nursing Fundamentals Potter Perry 12e Part 3 p. 123-125

E6 Nursing Fundamentals Taylor p. 412-414

E6 Physiology Ganong 27e Vol 1 Part 2 p. 19-21

Practise the full JIPMER Nursing Officer - 2020

Attempt every question from this paper in a timed mock, then review the full solution for each one.