Behavior and Mental Status Flashcards
T/F Depression is the leading cause of disability world wide
True
what are five physical symptoms of depression
- Fatigue
- Sleep disturbances
- musculoskeletal pain
- headache
- GI problems
Approx what percent of unexplained symptoms are related to depression
50%
T/F Sleep disturbances happen when a patient wakes up frequently in the night
false, it can mean getting too much sleep as well as too little
when should a mental health screen be performed
there are many possible key factors but the US preventative service task force reccommends one for all patients
what are the five components of a mental health exam
- apperance and behavior
- speech and language
- mood
- thoughts and perceptions
- cognitive function
what four patient qualities should be examined when assessing apperance and behavior
- level of consciousness
- posture and motor behavior
- dress/grooming/hygiene
- manner/affect/relationships
what are five ways to describe level of consciousness
- alert
- lethargic
- obtunded
- stupor
- coma
three indicators a person is alert
- responds to normal tone of voice
- good eye contact
- appropriate responses
three indicators a person is lethargic
- drowsiness
- opens eyes only to look at you
- responds to questions then falls asleep
five indicators that a patient is obtunded
- opens eyes to look at you
- responds slowly
- somewhat confused
- decreased alertness
- might need a shake awake
three indicators a patient is stuporous
- arouses only with painful stimuli
- slow or absent verbal response
- minimal awareness of environment
two indictors of a comatose patient
- unrousable with eyes closed
- no response to painful stimuli
what are four ways to introduce painful stimuli
- trap squeeze
- sternal rub
- pencil on nail bed
- pinch
what are four examples of abnormal posture and motor behavior
- pacing
- abnormal posture
- spastic movement
- complaining of a level of pain that doesn’t match presentation
what are 4 examples of variation in affect
- labile
- blunt
- exaggerated
- pleasant
labile affect
someone who expresses in appropriate or excessive displays of emotion
when assessing manner/affect/relationships what are five factors to examine
- affect
- level of approachability
- appropriate reactions to others
- possible hallucinations
- euphoria
what are five ways to evaluate speech and language in a mental health exam
- quantity
- rate
- volume
- articulation
- fluency
pressured speech
an abnormal speech pattern where the patient continuously talks with no breaks
what are two issues that might present with pressured speech
- mania
- substance abuse
what are three issues that might present with slowed speech
- depression
- stroke
- sedation
T/F slowed speech can involve speaking slowly or the inability to get words out
true
four disorders of speech
- aphasia
- apraxia
- dysarthria
- dysphonia
what is aphasia
a communcation disorder caused by damage to the language centers of the brain
what is the defining characteristic of aphasia
difficulties communicating (speech, writiing, reading) with no decrease intelligence
apraxia
a motor disorder in which the signal conduction from the brain to the mouth is interrupted, causing the person to be unable to move their mouth properly to speak
dysarthria
a motor speech disorder resulting from impaired muscles used in speech
what determines the type and severity of dysarthria
the area of the nervous system that is affected
dysphonia
a voice disorder caused by impairment of the mouth, tongue, throat, or vocal cords resulting in hoarseness
what is the goal of assessing a patients thoughts and persceptions during a mental health exam
the assess the logic, relevance, organization, and coherence of a patients thought process
what are 5 examples of a derranged thought process
- circumstantial
- tangential
- flight of ideas
- incoherent
- echolalia
what are circumstantial thoughts? what disorder might they indicate
speech with pointless, unnecessary detail
OCD
what are tangential thoughts? what disorder might they indicate
shifting between unrelated topics
psychotic
if a patient was described as having a flight of ideas, what kind of thought process would that describe? What might be the cause
non-stop, pressured speech with quickly changing topics
severe schizophrenia
what is echolalia? what might it indicate
repetition of words and phrases of others
mania, schizophrenia, autism
what is a good method to encourage a patient to describe there thought content
follow their lead, ask open ended questions
what are five terms to describe the content of a patients thoughts
- complusions
- delusions
- phobias
- anxiety
- obessions
compulsion
a repetitive response to a stimuli
obession
recurrent, persistant thoughts, feelings, or urges
phobias
persistent, irrational fears
delusions
false, fixed beliefs
three types of delusion
- persecutory
- grandiose
- erotomania
persecutory delusion
the feeling someone is out to get them
grandiose delusions
an inflated sense of importance
erotomania
the delusion that another person is in love with the patient but has not reason to be
what are six types of hallucinations
- auditory
- visual
- olfactory
- gustatory
- tactile
- somatic
what is the most common form of hallucinations
auditory
how might a patient behave tactile hallucinations
an exaggerated reaction to a imagined stimuli (somone touched my head)
somatic hallucinations
believing your body is filled with parasites
what are five ways to examine cognitive function
- orientation
- attention
- remote memory
- recent memory
- new learning ability
what are three ways to test attention
- digital span
- serial 7s
- spelling backwards
how to test remote memory
asking to recall past events
how to test learning ability
give the patient three words to remember, have them repeat the words, then ask them again in 3-5 minutes
what are four ways to test higher cognitive function
- knowledge and vocabulary
- calculating ability
- abstract thinking
- constructional ability
what is one way to test abstract cognitive ability
ask the patient to define a common proverb
what is one way to assess a patients constructional ability
ask them to draw a shape or a clock
what is the most widely used cognitive test for dementia in the US
the mini-mental state exam
what are the six factors tested on the mini-mental state exam
- orientation
- recall
- attention
- calculation
- language
- constuctional praxis
what are two weaknesses of the mini-mental health exam
- not sensitive to severe or mild dementia
- maybe influenced by age, education, language, etc
