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Nurs 202 > Lecture 5 Mental Health > Flashcards

Lecture 5 Mental Health Flashcards

1
Q

Mental Health

A

Balance in emotional and cognitive abilities that allow a person to manage life’s stressors

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2
Q

Mental Status

A

Component of mental health that includes emotional and cognitive functioning

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3
Q

Mental illness/disorder

A

Severe enough to cause disfunction

co-occurring symptoms that may involve alterations in thought, experience, and emotion … serious enough to cause distress and impair functioning

If managed not illness

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4
Q

Indication for a full mental health exam

A

Abnormality in mood, behaviour, memory loss, inappropriate social interactions

Brain Lesions

Aphasia (without language) (stroke)

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5
Q

Factors Affecting Findings

A

Health Problem (Substance use, alcoholism, losing mental status)

Medication

Baseline educational and behavioural level

Personal History

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6
Q

Mental Status Exam

A

Structured way of observing and describing a person’s current state of mind

Reflects the examiner observation and impressions at the time of the interview, an evaluation of the individuals current state

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7
Q

Mental status exam: Components (emotional/cognitive)

A

Appearance (E)
Behaviour (E)
Cognition (C)
Thought processes (C)

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8
Q

Appearance (PBDG) (E)

A

Posture (erect , relaxed)

Body movements (Voluntary, deliberate, coordinated, smooth, even)

Dress(Appropriate for season, age, social group, fits and put on appropriately)

Grooming and hygiene (Clean, well groomed )

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9
Q

Behaviour CFSM/A (E)

A

Level of Consciousness

Facial Expression (appropriate to situation, eye contact)

Speech (effort, voice level, pace, articulation, word choice

Mood and Affect (how someone feels and emotional expression)

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10
Q

Level of Consciousness

A 
Alert
Lethargic
Obtunded
stupor
Coma
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11
Q

Alert

A

Awake or readily aroused

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12
Q

Lethargic

A

drowsy but opens eyes to speech, respond to questions then falls asleep
when not stimulated

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13
Q

Obtunded

A

opens eyes to loud shout or shake, respond slowly, speech mumbled, confused

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14
Q

Stupor

A

responds only to shake or pain, groans, reflexes present

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15
Q

Coma

A

completely unconscious, no response to pain, +/- reflexes

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16
Q

Aphasia

A

Without speech

17
Q

Dysphasia

A

Diffcult speech

18
Q

Dysphonia

A

Abnormal voice

19
Q

Dysarthria

A

Abnormal articulation

20
Q

Mood

A

How someone feels(sustained emotion)

Overall emotion

21
Q

Affect

A

Emotional expression (display of feelings)

Affect should be appropriate to mood and change with topics

Abnormal: Flat, irritable, labile( rapid shift of emotion, intense happiness followed by intense sadness) , in appropriate

22
Q

Cognitive (OAIRRN) (C)

A

Orientation (time, place, person, self)

Attention span

Immediate memory

Recent memory (24 hours)

Remote memory

New learning (5m,10,30)(person under 60= 3 or 4, over 80 = 2) (no rhyming words when using four unrelated word test)

Note only use verifiable events

23
Q

Insight

A

Ability to recognize consequences

24
Q

Judgement

A

Ability to evaluate options and reach a logical decision (impulse)

25
Q

Thought Process (C)

A
  • Though process- the WAY the PT thinks
  • Thought content – WHAT the pt says
  • Perception- pts awareness of reality
  • *Know page 100 (Jarvis, 2014) Tables 6-4 & 6-5 (FOR MIDTERM)
26
Q

Thought Process

A

Should be logical, goal directed coherent, and relevant

o Abnormal: blocking, confabulation, clanging

27
Q

Thought Content

A

o Should be consistent and logical
o Abnormal: Obsessions compulsions, fears, delusions (false beliefs attached to a genuine perception with no rational, thinks theyre superman)

28
Q

Perception

A

o Should be consistently aware of reality
o Abnormal: Illusions (have an external stimuli, see shadows thinks theres someone, its just clothes), hallucinations (no external stimuli, is not there)

29
Q

Mental Status exam and the Older adult

A

• Important to conduct a brief mental status exam on all older individuals
• Check sensory status before assessing
o They cant hear you theyre not doing bad
• No decrease in knowledge, intelligence, remote learning and vocabulary. Recent memory and response times may decrease somewhat.

30
Q

MoCA or the Set Test

A 
o	Fruits, animals colours and towns
o	State 10 in each category
o	1 point for each category 
o	Nobody with a score greater then 25 have dementia
	Draw back is it’s a verbal test
•	Aphasia
31
Q

Mini-mental state exam

A 
•	Screening for cognitive impairment
•	Disadvantages:
o	May not identify mild cognitive impairment
o	Does not identify changes in existing dementia
•	Advantages:
•	Short administration time
o	Easy to use
o	Inexpensive
32
Q

Mental Health History

A
  • Nutritional patterns
  • Sleep
  • Activity
  • Interpersonal relationships
  • Spirituality
  • Coping/Stress management
33
Q

RISK ASSESSMENTS

A

Screen for:

Suicidal Thoughts

Assaultive/ Homicidal ideation

Elopement Risk
 Make them wear hospital clothes

34
Q

Suicidal Thoughts (IPLAS)

A

 Intent- Do you have thoughts of harming yourself
 Plan- do you have a plan to harm yourself
 Lethality- What do you plan to use
 Access- Do you have access to the means
 Safe Contract- will you agree to be safe while here

35
Q

Risk Factors for Suicide

A 
•	Precise plan with access to lethal meaning in the next 24-48 hours
•	Prior attempts
•	Depression, hopelessness
•	Social withdrawal
•	Self-mutilation
•	Verbal suicide message
•	Death themes in art, jokes, writing
•	Family history of suicide
o	Those with a plan have a higher chance of doing it
36
Q

Aphasia testing

A

Word comprehension, reading, writing

Nurs 202 (20 decks)

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