Mental Health Powerpoint Flashcards
Mental Status Assessment
Appearance in terms of hygiene, are they dressing appropriately for the weather or are they completed ____________ and that is not a normal appearance for them, do they look __________? Do they look exhausted?
Appearance can tell us a lot about someone and where they are at
Level of consciousness= are they __________ as your talking to them, are their sentences not making sense, do they know where they are?
Memory-short term vs long term
What is their speech like….is it __________? Is it _______? Is it making sense? Is it too slow?
Motor behavior (mechanical)…maybe you notice a tremor…anything related to their arms maybe when they are walking or are they walking normally…their thought processes or are they having normal complete though process…are they talking about things unrelated and just not relevant to the visitor or what your talking about
Does there affect and their mood seem appropriate? (Some people may have a flat affect which is no emotion, maybe their mood or they are coming in completed amped up,stressed, sometimes might vent for an hour before you even get to talk to them about diabetes
mismatched
disheveled
falling asleep
racing
fast
In assessing someone’s mental states your using both your observations and the history that we are taking from the pt
When you call 988 there might be a brief hold because they trying to find a counselor to help whoever is calling so its not immediate within a couple minutes or so
Are you thinking about killing yourself? Are you thinking about suicide
___________ is diagnosed with DSM-5…don’t have to remember specific criteria professor said but have to know this.. THERE HAS TO BE 5 OR MORE SYMPTOMS WITH ONE OF THEM BEING DEPRESSED MOOD OR LOSS OF INTEREST OR PLEASURE IN DOING THINGS over a two week period of time
Depression
PHQ-9 the series of questions related to sleeping, thinking, concentrating, thoughts of harming yourself, thoughts of that you would better off dead and how often are these things happening or have been happening in the last 2 weeks, based on the frequency of that the more frequent it is, the higher the point score…the higher the point score the more of a depressive disorder
Anyone that has a major depressive episode based on that score that’s a referral to a behavioral health specialist and if there’s minor maybe someone is working with therapist maybe not…maybe pt needs additional support…what support system do you have? Do you have a support system? Can we find support groups in the area?
Onset with delirium is usually very acute and rapid
Dementia and depression are more gradual in onset these things occur overtime
In depression symptoms have to be occurring for at least _________
2 weeks
Dementia symptoms occur for longer than a _________
month
Delirium is ___________ in terms of symptoms
less than 1 month
Delirium there isn’t accurate thought processes…same thing with dementia
In depression, pt will have normal perception (they know where they are and who the president is)
Mini-mental state exam is used to detect __________…several questions being asking, there is some drawing…where you have to copy some designs and draw other things, you have to write a sentence, there’s recall…your really getting at cognitive function of pt
dementia
If someone had a stroke and so if you lose some of that function on one side and not the other your going to see the differences in a neuro exam
Trigeminal cranial nerve so we are going to have something sharp and something soft and you will be able to sense that in your hands
Cranial Nerve 8-trying to assess hearing and whether hearing loss due to conduction or due to nerve
We are going to take that tuning fork and hit it our hand and make it vibrate and we are going to put on the top of our head and your going to feel it vibrating…ideally its symmetrical which is normal…its normal to put that on the top of head and symmetry its vibrating equally
If it vibrates and you only feel the sensation to the ear that your having trouble hearing from, then it’s a conductive loss
If it goes to the ear that your not having trouble hearing from then its neural and it’s a way to figure out whats the cause of the hearing loss that’s the weber test
Rhine test-air conduction of the vibration to the bone conduction of the vibration so here its saying that a normal air conduction is heard longer than feeling the bone conduction
So if you have someone with a ruptured eardrum or a ton of wax or an ear infection then you may have conductive loss which means the bone is going to be vibrating longer than you can hear it so we take the tuning fork that is vibrating and just put it outside the ear can you hear it vibrating if you can hear it your good, make it vibrate and take the handle and put it on the bone behind your ear…can you feel it vibrating…which do you hear or feel longer…your assessing whether its conductive or sensorineural
_____- will ask you to walk or walk away, walk towards, walk backwards, walk on tipy toes, walk on your heels whats the balance like whats the gait like, are the arms swinging they are suppose to swing
Gait
________test-if someone sways you know you have motor disturbance going on
Romberg
__________: Letter drawing is one stroke…like the letter C
Graphesthesia
