Chapter 5 - Mental Status Assessment

Question 1

A person’s emotional (feeling) and cognitive (knowing) function.

• Assessed by evaluating a person’s consciousness, language, mood and affect, orientation, attention, memory, abstract reasoning, thought process, thought content, and perception

Answer 1

Mental Status

Question 2

A state of well-being in which every individual realizes his or her own potential, can cope with normal stresses of life, can work productively and fruitfully, and is able to make contribution to his or her community.

Answer 2

Mental Health

Question 3

• Stress surrounding a traumatic life event (death of loved one, serious illness) that tips the balance in mental status and mental health.
• This a normal response to a trauma.

Answer 3

Transient Dysfunction (stress)

Question 4

• Conducted during a traumatic event in life
• Used to identify remain strengths and to help the individual gather resources and use coping skills.
• Documents a dysfunction and determines how that dysfunction affects self-care in everyday life.

Answer 4

Mental Status Assessment

Question 5

• When an individual’s response is much greater than the expected (normal) reaction to a traumatic life event.
• includes organic disorder and psychiatric mental disorder

Answer 5

Mental disorder

Question 6

• Clinically significant behavioral, emotional, or cognitive syndrome that is associated with significant distress (a painful symptom) or disability (impaired functioning) involving social, occupational, or key activities.

Answer 6

Mental Disorder

Question 7

Major depression - characterized by feelings that are unrelenting or include delusional or suicidal thinking, feelings of low self-esteem or worthlessness, or loss of ability to function.

Answer 7

Example of mental disorder.

Question 8

• Caused by brain disease of known specific organic cause.

- Example: delirium, dementia, alcohol and drug intoxication, and withdrawal.

Answer 8

Organic disorder

Question 9

• An organic etiology is not established

- Example - Anxiety disorder or schizophrenia

Answer 9

Psychiatric mental disorder

Question 10

• assess consciousness, language, mood and affect, orientation, attention, memory, abstract reasoning, thought process, thought content, and perception

Answer 10

Mental Status Assessment

Question 11

• Being aware of one’s own existence, feelings, and thoughts, and of the environment.
• The most elementary of the mental status functions.

Answer 11

Consciousness

Question 12

• Using the voice to communicate one’s thoughts and feelings.
• It’s loss has heavy social impact on the individual

Answer 12

Language

Question 13

• Dealing with prevailing feelings

Affect - temporary expression of feelings or state of mind, and mood

Mood - more durable, a prolonged display of feelings that color the whole emotional life.

Answer 13

Mood and Affect

Question 14

• Awareness of the object world in relation to the self, including person, place, and time.

Answer 14

Orientation

Question 15

• The power of concentration, the ability to focus on one specific thing without being distracted by many environmental stimuli.

Answer 15

Attention

Question 16

• Ability to lay down and store experiences and perceptions for later recal

Recent memory - evokes day to day events

Remote memory - brings up years’ worth of experiences

Answer 16

Memory

Question 17

• Pondering a deeper meaning beyond the concrete and literal

Answer 17

Abstract reasoning

Question 18

• The way a person thinks - logical train of thought

Answer 18

Thought process

Question 19

• What the person thinks - specific ideas, beliefs, the use of words

Answer 19

Though content

Question 20

• Awareness of objects through the five senses.

Answer 20

Perception

Question 21

Consciousness - gradually develops along with language
By 18-24 months - child learns he or she is separate from objects in the environment and has words to express it.

Language - crying at 4 weeks, cooing at 6 weeks, 1 word sentences at 1 years old and multi word sentences at 2 years old. Social communication at 4-5 years old

Attention - gradually increases through preschool years

Abstract thinking - 12-15 years old

Logical thinking at 7 years

Answer 21

Developmental Competence - Infants and children

Question 22

• Diagnosed and begins at childhood (ADHD, behavioral or conduct problems, anxiety, depression, Autism’s spectrum disorders)

Answer 22

Childhood mental disorder

Question 23

• 12-17 years experience illicit drug use or alcohol use disorder and cigarette dependence
• Presents as changes in how children learn, behave, or handle emotions.

Answer 23

Adolescents

Question 24

• No decrease in general knowledge and no loss in vocabulary
• Response time is slower than in youth
• Take longer to process information and react to it
• Slower response affects new learning
• Recent memory is decreased
• Loss of loved one can cause disorientation, disability, or depression.

Answer 24

Developmental Competence - The Aging Adult

Question 25

A - Appearance B - Behavior C - Congnition T - Thought process * important to full mental status emanation for any abnormality discovered (anxiety disorder or depression, bizarre behaviors, brain lesions, aphasia (imparted to language), symptoms of psychiatric mental illness,

Answer 25

Components of Mental Status Examination

Question 26

Appearance - Posture, body movements, dress, grooming and hygiene, pupils Behavior - Level of consciousness, facial expression, speech, mood and affect Cognitive Functions - Oreintation, attention span, recent memory, remote memory, new learning (the four unrelated word test), with Aphasia (Word compression, reading, writing) Thought processes and perception - thought processes, though content, perceptions, screen for anxiety disorders (GAD - 7) and depression (PHQ-9), screen for suicidal thoughts.

Answer 26

Objective Data

Question 27

- simplified scored assessment of cognitive functions (not mood or thought process) - brief assessment of memory, orientation to time and place naming, reading, copying or visual-spatial orientation, writing, and the ability to follow a 3 stage command.

Answer 27

Mini-Mental State Examination

Question 28

- The level of stimulus used, ranging progressively from - The person’s response - What the person does on cessation of your stimulus - (Person’s response in eye opening, best verbal response, and best motor response)

Answer 28

Glasgow Coma Scale

Question 29

- An acute confusional state, potentially preventable is hospitalized persons Characterized - disorientation, disordered thinking and perceptions, defective memory, agitation, inattention

Answer 29

Delirium

Question 30

- A chronic progressive loss of cognitive and intellectual functions, although perception and consciousness are intact Characterized by - disorientation, impaired judgement, memory loss

Answer 30

Dementia

Question 31

- A long-term depressed mood (greater than 2 weeks) with lack of pleasure; disturbed sleep and appetitive; feelings of hopelessness, guilt, worthlessness, sadness, loneliness, and despair; suicide ideation

Answer 31

Depression

Question 32

- brief screening suggest anxiety disorder or depression - family members express concern about behavioral changes - report of organic behavioral system (nocturnal wandering, concentration deficient, trouble with simple activities, inappropriate judgement, or linguistic difficulty - emotional or cognitive changes noted with brain lesion - language dysfunction (aphasia, agitation, or depression)

Answer 32

Full mental status is needed

Question 33

Consciousness, language, attention span, and abstract thinking all develop over time

Answer 33

Mental development

Question 34

Allows direct interaction with the young child to assess the mental status

Answer 34

Denver II screening test

Question 35

- a reliable, quick instrument to screen for cognitive impairment in otherwise healthy older adults

Answer 35

Mini-Cog

Question 36

- tests the person’s ability to lay down new memories and is highly sensitive and valid memory test.

Answer 36

The Four Unrelated Words Test

Question 37

- when he or she can compare and evaluate the alternatives in a situation and reach an appropriate course of action.

Answer 37

A person’s judgement

Question 38

- When the person is not fully alert, drifts off to sleep when not stimulated, and can be aroused when called by name in a normal voice but looks drowsy. - He or she appropriately responds to questions or commands, but thinking seems slow and fuzzy. - He or she is inattentive and loses the train of thought. - Spontaneous movements are decreased.

Answer 38

Lethargic/Somnolent

Question 39

- a transitional state between lethargy and stupor.

Answer 39

Obtunded

Question 40

- unconscious and responding only to persistent or vigorous shaking or pain.

Answer 40

Stuporous/Semi-coma