Mental Health Assessment Flashcards
what is mental status
A person’s emotional (feeling) and cognitive (knowing) function.
What does optimal functioning aim towards?
Simultaneous life satisfaction in work, caring relationships, and with self.
What is a mental disorder?
A situation is when a person has a response to a traumatic life event that is much greater than expected.
What are mental disorders characterized as?
Organic disorders (caused by a disease in the brain ex. Dementia)
Psychiatric disorders ( anxiety, schizophrenia)
What does a mental status assessment do?
Documents dysfunction; determines how the dysfunction affects self-care in everyday life.
Can mental disorders be directly assessed?
No. It’s functioning is inferred through assessment.
When do we complete a mental status exam?
Recent trauma resulting in a change in memory
Report of decline in cognitive ability
When a patient requires a thorough exam of emotional and cognitive functioning
What are the 4 major components of a Mental Status exam?
ABCT
- Appearance
- Behavior
- Cognition
- Thought processes and Perceptions
what are we looking at when assessing appearance?
Posture
Body Movements
Dress
Grooming & Hygiene
Pupils (drugs)
What are we looking at when assessing behavior?
Level of consciousness (LOC)
facial expression (appropriate for the situation)
Speech (fluent, slurred)
Mood and affect (appropriateness)
What are we looking at when assessing cognitive functioning?
Orientation
Attention span
Recent memory
Remote memory
New learning (4 unrelated words)
What are we looking at when assessing thought processes and perceptions?
Thought content (what they say is consistent and logical)
Perceptions (person should be consistently aware of reality)
Screen for anxiety
Screen for Depression
Screen for suicidal thoughts
What is dementia?
Chronic disturbance of consciousness and cognition. Gradual and progressive.
Long and short-term memory loss (short -term more pronounced)
Not a normal part of aging and not reversible.
What is delirium?
Acute (fast onset) disturbances of consciousness and cognition (develops over a short period of time.
Impaired memory (short-term)
Usually resolved when underlying cause is treated (UTI, dialysis, esp. older patients)
What are the levels of consciousness?
Alert
Lethargic (still responsive)
Obtunded (similar to lethargy, but more out)
Stupor/semi-coma (in and out)
Coma (completely out)
What is the difference between consciousness and cognition?
Consciousness refers to being alert or comatose
cognition refers to how well their brain is functioning, knowledge, memory
Glasgow Coma Scale
Describes level of consciousness.
Measures 3 areas:
Eye opening response
Motor response
verbal response
What is a normal score on the Glasgow coma scale?
Score of 15
What score denotes a coma on the Glasgow coma scale?
Score of <8
What is global aphasia
Most common, most severe.
speech is absent or only a few words. No comprehension, cannot repeat write, or read words.
What is Broca’s or Expressive Aphasia
Able to understand language
can’t express self-using language
Can’t repeat or read aloud
Auditory and reading comprehension are intact
Wernicke or Receptive Aphasia (word salad)
Can hear sounds but can’t relate to them
Speech is fluent, patient has a great urge to speak but words are made up and frequented with word substitutions; resulting in incomprehensible speech
Impaired repetition, reading, and writing. (If intake is poor, output is poor)
What is a Mini Mental Status Exam (MMSE)?
A test only for the cognitive functions of the mental status exam.
A total of 11 questions, takes 5-10 minutes.
Must be able to write and have no visual impairments.
What type of aphasia patients would not be able to take the Mini-Mental Status Exam (MMSE)?
Receptive aphasia (Wernicke) patients
Also comatose patients
Why should we talk slower and give older patient’s longer time to respond?
They don’t have a cognitive deficit, but their response time is slower and thought process takes longer.
