DAY ONE Flashcards
Good Mental Health
reflects a positive approach to life; stressful events can be challenges, not difficulties. Helps determine relationships and choices
Declining or Poor Mental Health
mental health starts to decline but is not a diagnosable mental illness
Mental Illness
difficulties in thinking, mood and/or behaviour associated with substantial distress and general dysfunction
Continuum of Mental Health: MILD
Joys, sorrows, and anxiety levels that aid in the work of living
Continuum of Mental Health: MILD TO MODERATE
Psychophysiologic factors affecting medical conditions
Continuum of Mental Health: MODERATE TO SEVERE
Anxiety disorders, dissociative disorders, Somatoform disorders, Personality disorders, Eating disorders
Continuum of Mental Health: SEVERE TO PSYCHOSIS
Depressive disorders, Bipolar disorders, Schizophrenic disorders, Cognitive disorders
Top 3 Mental Illnesses in Canadians
Major Depression, Substance Abuse, Generalized Anxiety
Risk Factors of Mental Illness
- appears to “run in families” but also linked to events and environment
- lifestyle choices and learned thoughts and behaviours can influence
- Unhealthy choices
Cause of Mental Illness: INTERNAL FACTORS
- Genetics
- Neurochemistry
- Biologic vulnerability
- Personality
Cause of Mental Illness: EXTERNAL FACTORS
- Social Determinants of Health
- Stress
- Coping Skills
- Adverse Childhood Experiences
Assessments on Mental Health
- Personal History
- Presenting Problem
- History of Presenting Problem
- Medical History
- Mental Status Assessment/Exam
- Geno/Eco Map
- MMSE
- Geriatric Depression Scale
- Panic Attack Questionnaire
- Collaboration with family
What does Mental Status Assessment/Examination do?
- detects changes or abnormalities in intellectual functioning, thought content, judgment , mood, affect
- may help identify possible brain lesions
- like a physical examination in general medical nursing
- does not reflect a patient’s past or future; evaluated patient’s current state
What are the categories of mental status examination?
- Appearance
- Behaviour
- Speech
- Mood/Affect
- Thought Perceptions
- Sensorium and Cognition
- Ideas of Harm
General Observations for APPEARANCE
Apparent age
Manner of dress
Cleanliness
Posture/gait
Facial expressions
Eye contact
Pupil dilation or constriction
General state of health, nutrition
Observations for Behaviour
Motor activity
1. Level of activity (lethargic, tense, agitated)
2. Type of activity (tics, grimaces, tremors)
3. Unusual gestures/mannerisms (compulsions)
Eye Contact
Rapport
1. Openness to interview (resistive, open)
Observations for Speech
Rate: rapid or slow
Volume: loud or soft
Tonality: monotone, tremulous
Amount: paucity, muteness, pressured speech
Articulation: Slurring, stuttering, mumbling, unusual accents
Organization: Disorganized, tongued tied
Quality: poverty of speech, plentiful, articulate, vague
Observations for Mood (Subjective)
“How are you feeling today?”
Ask patient to rate his/her mood on 0-10 scale
What does the 0-10 scale do?
- provide immediate reading
- valuable to compare changes during treatment
Qualities of Affect (Observed)
Range
Duration
Intensity
Appropriateness
( Joy, Surprise, Anger, Contempt, Sadness, Disgust, Fear)
How would you describe Affect?
Flat affect
Restricted or blunted
Labile
Stable
Incongruent
Congruent
What is Thought Content?
WHAT the person is thinking
Specific meaning expressed in patient’s communication
Throughout interview, important the nurse obtains information but does not dispute patient’s beliefs
What is Thought Process?
HOW the person is expressing thoughts
Patient’s thought process observed through speech patterns or forms of verbalization rather than content.
