HYHO: Altered Mental Status Flashcards
What is the five model approach to altered mental status?
- Biomech: loss of ms/bone, OA
- Neuro: dec brain weight, memory, sleep, gait
- Resp: CV, resp ms strength
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Metab/Immune: T-cell fxn, gastric acid, colonic mot, Ca abs
- Check skin for signs of breakdown
- Abd for constipation
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Behav: cognitive changes and dec mobility
- ST techniques for depression
What is battle’s sign?
brusing over mastoid process(es) caused by extravasation of blood along posterior auricular artery
sign of head trauma
What is hemotympanum?
presence of blood in tympanic cavity of the ear
often result of basilar skull fracture
What aspects of an exam should be included in a pt with altered mental status?
Vitals
General appearance
HEENT
Neuro Testing
What helps to prevent delerium during hospital stays?
exercise
What is the strongest risk factor for dementia?
advanced age
What are the four main considerations for a dementia dx?
What does I WATCH DEATH stand for?
ddx for delirium
What two tests are done for delirium?
Richmond Agitation Sedation Score
Confusion Assessment Method
What four tests are done for dementia?
Mini-cog
Montreal Cognitive Assessment
Mini-Mental State Exam
Saint Louis University Mental Status Examination
What are these tests used for?
CAM, bCAM, RASS
CAM = conf assesment method
- screens for delirium by non-psychiatrists
bCAM = brief CAM
- used w RASS to screen for delirium in ED
RASS = richmond agitation sedation scale
- asses level of alertness in mechanically ventilated pt
- to avoid over or under sedation
What should you not give a patient with delirium?
Benzos = can have paradoxical stimulating effect
What is the first step when working up a pt with dementia?
Rule out depression
Make sure you can add things to be able to calculate a Glasgow Coma Score
Like memorize it I guess
TEST QUES
