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mental assessment Flashcards

1
Q

Mental Status

A

Refers to a person’s emotional (feeling) and cognitive (knowing) function.

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2
Q

Mental Health

A

A state of well-being in which individuals realize their own potential, cope with normal life stresses, work productively, and contribute to their community.

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3
Q

Level of Consciousness

A
  • Lethargic: Drowsy, not fully alert; drifts to sleep when not stimulated.
  • Obtunded: Sleeps, difficult to arouse with loud/vigorous stimuli; acts confused when aroused.
  • Stupor: Semi-comatose; responds only to shaking or pain; has appropriate motor responses.
  • Coma: Completely unconscious; no response to pain or external stimuli.
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4
Q

Emotional State

A
  • Labile: Rapidly shifting emotions.
  • Flat Affect: No emotional response; very monotone.
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5
Q

Lethargic

A

Drowsy, not fully alert; drifts to sleep when not stimulated.

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6
Q

Obtunded

A

Sleeps, difficult to arouse with loud/vigorous stimuli; acts confused when aroused.; sternal rub to wake them up

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7
Q

Stupor

A

Semi-comatose; responds only to shaking or pain; has appropriate motor responses.

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8
Q

Coma

A

Completely unconscious; no response to pain or external stimuli.

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9
Q

Labile

A

Rapidly shifting emotions.

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10
Q

Flat Affect

A

No emotional response; very monotone.

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11
Q

CAGE Questionnaire

A

A subjective tool used to screen for alcohol history and psychosocial associations. Questions include:
1. Cut down?
2. Annoyed?
3. Guilty?
4. Eye-opener? (drink when they wake up)

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12
Q

CIWA Scoring

A

An objective tool (Clinical Institute Withdrawal Assessment) used to assess/treat alcohol withdrawal and detox; assesses the level of risk and type of treatment given.

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13
Q

Alcohol (Depressant)

A
  • Unsteady gait
  • Slurred speech
  • Labile emotions
  • Tremors (with withdrawal)
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14
Q

Marijuana (Depressant)

A
  • Tranquility
  • Paranoia, suspiciousness
  • Increased appetite
  • Nausea, vomiting (with CHS - cannabis hyperemesis syndrome)
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15
Q

Opioids (Depressant)

A
  • Lethargy
  • Depressed vital signs
  • Pinpoint pupils
  • Impaired occupational function
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16
Q

NARCAN

A

An opioid antagonist used to reverse opioid overdose.

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17
Q

Cocaine (Stimulant)

A
  • Hypervigilance
  • Weight loss
  • Pupillary dilation
  • Tachycardia
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18
Q

MDMA, Ecstasy/Molly (Stimulant)

A
  • Extroversion
  • Emotional warmth
  • Seizures
  • Often mixed with other drugs (e.g., stimulants)
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19
Q

PCP, Angel Dust (Stimulant)

A
  • Increased strength
  • Seizures, possible death
  • Reduced perception of pain
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20
Q

Glasgow Coma Scale (GCS)

A

A tool used to assess a patient’s level of consciousness and neurological functioning.

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21
Q

Eye Opening Response

A
  • 4: Spontaneous (eyes open spontaneously)
  • 3: To verbal command (eyes open to verbal stimuli)
  • 2: To pain (eyes open in response to painful stimuli)
  • 1: No response (no eye opening)
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22
Q

Verbal Response

A
  • 5: Oriented (responds appropriately to questions)
  • 4: Confused (disoriented but able to answer questions)
  • 3: Inappropriate words (random or exclamatory speech)
  • 2: Incomprehensible sounds (moaning but no words)
  • 1: No response (no verbal response)
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23
Q

Motor Response

A
  • 6: Obeys commands (follows simple commands)
  • 5: Localizes pain (moves toward painful stimuli)
  • 4: Withdrawal (withdraws from pain)
  • 3: Flexion (abnormal flexion to pain)
  • 2: Extension (abnormal extension to pain)
  • 1: No response (no motor response)
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24
Q

Total GCS Score

A

3-15:
- 3: Deep coma or death
- 8 or less: Severe head injury (coma)
- 9-12: Moderate head injury
- 13-15: Mild head injury (fully conscious)

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25
Q

GCS Interpretation

A
  • A lower score indicates a more severe level of impaired consciousness and neurological function.
  • Used frequently in emergency settings to assess brain injury severity.
26
Q

Level of Consciousness (LOC)

A

Assessed first to gauge overall mental status before using the ABCT framework.

27
Q

ABCT Framework

A

A: Appearance, B: Behavior, C: Cognition, T: Thought processes.

28
Q

Appearance

A
  • Posture: Stance and body positioning.
  • Body movements: Are movements purposeful?
  • Dress: Appropriate for setting and situation?
  • Hygiene and grooming: Indicators of self-care behaviors.
  • Pupils:
  • Dilated pupils → cocaine use
  • Pinpoint pupils → opioid use
29
Q

Behavior

A
  • Facial expression: Is it appropriate for the situation?
  • Eye contact: Level of engagement.
  • Speech: Pace, articulation, and word choices.
  • Cultural awareness: Consider cultural variations in behavior.
30
Q

Mood and Affect

A
  • Body language/facial expression: Observe non-verbal cues.
  • Ask: “How do you feel today?”
  • Mood abnormalities:
  • Depression: Sad, gloomy.
  • Flat affect: Lack of emotion.
  • Elation: Joy, optimism.
  • Lability: Rapid shifts in emotions.
  • Anxiety: Worrying.
  • Euphoria: Excessive well-being.
31
Q

Cognition

A
  • Orientation:
  • Person, place, time (O x 3); situation (O x 4).
  • Attention span:
  • Serial commands to assess focus.
  • Recent memory: Recall events from the last 24 hours.
  • Remote memory: Long-term memory questions (anniversaries, first jobs).
  • New memory: 4 unrelated words tested after 5/10/30 minutes.
  • Judgment: Evaluate future plans, realistic expectations.
32
Q

Thought Processes and Perceptions

A
  • Thought processes: Are thoughts logical and coherent?
  • Perceptions:
  • Ask about feelings of being watched, followed, or controlled.
  • Screen for anxiety:
  • Questions from the Generalized Anxiety Disorder Scale (GAD).
  • Suicidal thoughts:
  • Directly ask about feelings of self-harm, hopelessness, and plans for suicide.
33
Q

Abnormal Perceptions

A
  • Hallucinations: Sensory perceptions with no external stimuli (e.g., visual, auditory).
  • Illusions: Misrepresentation of actual stimuli (e.g., faces on money appearing to move).
34
Q

The Aging Adult

A
  • Aging adults should not exhibit decline in general knowledge and abilities; response time may be slower.
  • Delirium: Acute confusional state, often reversible when the underlying cause is treated.
  • Dementia: Gradual decline in cognitive function, not reversible and not part of normal aging.
35
Q

Possible Contributing Factors to Cognitive Deficits

A
  • Medications: (e.g., antipsychotics, sedatives, cocaine).
  • Illnesses: Acute or chronic conditions.
  • Delirium/Dementia: Recognize baseline behavior and assess changes.
  • Age and Culture: Consider cultural norms in behavior and communication.
  • Education: Impact on cognitive function and responses.
  • Sensory deficits: Vision and hearing impairments may affect communication and assessment.
36
Q

Body language/facial expression

A

Observe non-verbal cues to assess emotional state.

37
Q

How do you feel today?

A

Question to gauge the individual’s current emotional state.

38
Q

Mood abnormalities

A

Variations in emotional responses that may indicate mental health issues.

39
Q

Depression

A

Characterized by feelings of sadness and gloominess.

40
Q

Flat affect

A

A lack of emotional expression, appearing very monotone.

41
Q

Elation

A

Feelings of joy and optimism.

42
Q

Lability

A

Rapid shifts in emotions.

43
Q

Anxiety

A

Persistent feelings of worry and nervousness.

44
Q

Euphoria

A

Excessive feelings of well-being and happiness.

45
Q

Orientation

A

Awareness of person, place, time (O x 3), and situation (O x 4).

46
Q

Attention span

A

Assessed through serial commands to evaluate focus and concentration.

47
Q

Recent memory

A

Recall of events from the past 24 hours.

48
Q

Remote memory

A

Long-term memory recall (e.g., anniversaries, first jobs).

49
Q

New memory

A

Recall of 4 unrelated words tested after 5, 10, and 30 minutes.

50
Q

Judgment

A

Evaluation of future plans and realistic expectations.

51
Q

Hallucinations

A

Sensory perceptions that occur without external stimuli, such as visual or auditory experiences.

52
Q

Illusions

A

Misrepresentations of actual existing stimuli, for example, seeing faces on moving money.

53
Q

Delirium

A

Acute confusional state, often reversible when the underlying cause is treated.

54
Q

Dementia

A

Gradual decline in cognitive function, not reversible and not part of normal aging

55
Q

Medications

A

Examples include antipsychotics, sedatives, and cocaine that may affect cognitive function.

56
Q

Illnesses

A

Refers to both acute and chronic conditions that can impact cognitive abilities.

57
Q

Delirium/Dementia

A

Importance of recognizing baseline behavior and assessing changes over time.

58
Q

Age and Culture

A

Consideration of cultural norms in behavior and communication styles during assessments.

59
Q

Education

A

The impact of educational background on cognitive function and responses to assessments.

60
Q

Sensory deficits

A

Vision and hearing impairments that may affect communication and the effectiveness of assessments.

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