Cognition

Question 1

Where is Glasgow Coma Scale most often used?

Answer 1

Normally it is used in an emergent situation, but it can be used in acute care

Question 2

What does the Glasgow Coma Scale tell you?

Answer 2

The levels explain likely outcomes, but it is not determinant of how a person will progress

Question 3

What is a severe score in the Glasgow Coma Scale?

Answer 3

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They are likely to have long term damage. Something won’t return.

Question 4

What is a moderate score on the Glasgow Coma Scale?

Answer 4

9-12

Question 5

What is a likely outcome for a moderate score?

Answer 5

They could go either way. They likely won’t regain 100% of function, but they could be functional.

Question 6

What is a mild score on the Glasgow Coma Scale?

Answer 6

13-15

Question 7

What is a likely outcome for a mild score?

Answer 7

There is a chance that all of their function will return.

Question 8

Describe affect

Answer 8

Affect is the patient’s immediate emotion. It is like the weather.

Question 9

What are the three categories used to describe affect?

Answer 9

Range: blunted/restricted, flat
Appropriateness: inappropriate, incongruent (actions don’t match mood. They are happy, but there is nothing on their face)
Stability: labile (rapidly changing)

Question 10

What is a patient’s mood?

Answer 10

Mood is a more long term emotional state. It is like the season the patient is in

Question 11

What are three categories of mood?

Answer 11

Happiness (ecstatic, elevated, depressed)
Irritability (explosive, calm)
Stability: do they change a lot. Up and down all the time or stable.

Question 12

Describe Wernicke’s aphasia

Answer 12

Also known as receptive aphasia. They have trouble understanding things. They can speak, but it won’t make sense in the situation or their sentences won’t fit together. They don’t know what you’re saying to them.

Question 13

Describe Broca’s aphasia

Answer 13

Also known as expressive aphasia. They can understand what you are saying, but they have trouble word finding. Their brain can’t get the right words out.

Question 14

What is global aphasia?

Answer 14

A combination of Wernicke’s and Broca’s. All of them can affect both spoken and written word.

Question 15

What are things you should NOT do when speaking to a non-english speaking patient?

Answer 15

Don’t speak louder.

If you do not have to, don’t use an interpreter that is a family member.

Question 16

What are things you should do when using an interpreter?

Answer 16

Speak directly to the patient not to the interpreter.
Ask shorter, purposeful questions, so the interpreter doesn’t have to remember a long story.
Speak clearly and slowly.
Change the phrasing of the question if they don’t understand

Question 17

How do you accommodate vision impairment?

Answer 17

Do not demonstrate things for them.

Question 18

Before you give someone a home program, what should you ask?

Answer 18

Want to ask them about their learning preferences. They may want you to explain, demonstrate, give them a paper, or have them try it.

Question 19

How do you accommodate different education levels?

Answer 19

Speak to them on their level. Not demeaning but using language common to their level of education. If you are treating a physician, you speak differently than when speaking to someone with a high school diploma.

Question 20

What are some strategies to handle angry patients?

Answer 20

• Pay attention to their behavioral cues and body language. Gently point it out.
• Put yourself in their shoes
• Take responsibility
• De-escalate. May be rational, may be emotional