Mental Status

Question 1

Mental status assessment

Answer 1

• mental status is a person’s emotional (feeling) and cognitive (knowing) fxn
• plays a role in life satification, work, caring relationships and within self
• cant be directly seen, touched or ausculated
• will affect a patients daily well-being and ability to cope with stressful situations

Question 2

mental health

Answer 2

• A state of well being in which every individual realizes his or her own potential & can cope with normal stresses of life, can work productively and can make a contribution to their community

Question 3

mental disorder

Answer 3

• Is apparent when a person’s response is much greater than the expected reaction to a traumatic life event.
• Clinically significant behavioral, emotional, or cognitive syndrome that is associate with significant distress (painful symptom) or disability (impaired functioning)

Question 4

organic disorder

Answer 4

• Caused by brain disease of known specific organic causes Delirium, dementia, alcohol or drug intoxication, withdrawal

Question 5

Psychiatric mental disorder

Answer 5

• In which an organic etiology has not yet been established

Question 6

consciousness

Answer 6

Being aware of one’s own existence, feelings and thoughts of the environment

Question 7

language

Answer 7

using the voice to communicate one’s thoughts and feelings

Question 8

mood and affect

Answer 8

Affect=temporary expression of feelings or state of mind

Mood= more durable, a prolonged display of feelings that color the whole emotional life

Question 9

orientation

Answer 9

The awareness of the objective world in relation to the self, including person, plaace and time

Question 10

Attention

Answer 10

The power of concentration, the ability to focus on one specific thing without being distracted by many environemental stimuli

Question 11

Memory

Answer 11

The ability to lay down and store experiences and perceptions for later recall, Recent memory evokes day-to-day events; remote memory brings up years worth of experiences

Question 12

Abstract reasoning

Answer 12

Pondering a deeper meaning beyond the concrete and literal

Question 13

Thought processes

Answer 13

The way the person thinks; the logical train of thought

Question 14

Thought content

Answer 14

what the person thinks, specific ideas, beliefs and use of words

Question 15

perception

Answer 15

an awareness of objects through the five senses

Question 16

Flat affect (blunted affect)

Answer 16

• lack of emotional response; no expression or feelings
• voice monotone and face immobile

Question 17

inappropriate affect

Answer 17

discordant with content of person’s speech
(laughts wile discussing admission for liver biopsy)

Question 18

flight of ideas

Answer 18

abrupt change, rapid skipping from topic to topic, practically continuouts flow of accelerated speech; topics usually have recognizable associations or are play on words

Question 19

word salad

Answer 19

incoherent mixture of words, phases and sentences; illogical, disconnected, includes neologisms

Question 20

confubulation

Answer 20

Fabricates events to fill in memory gaps

Question 21

mental status exam

Answer 21

• Mental status is inferred by assessing a patient’s appearance, behaviors, cognition, & thoughts (ABCT)
• Integrating the mental status examination into the health history is sufficient for most people.
• Perform a full mental status examination when you discover any abnormality.
• Anxiety or depression
• Family Member concern (memory loss, inappropriate social interaction)
• Bizarre behavior, concentration problems, inappropriate judgment
• Aphasia
• Symptoms of psychiatric mental illness
• Areas that could affect your interpretations:
• Illness or health problems (ex. alcohol use or chronic renal disease)
• Current medications (ex. side effects could cause confusion or depression) Education and Behavioral level (what is their normal baseline?)

Question 22

posture

Answer 22

Expected findings- should be erect in relaxed position

Unexpected findings- sitting on edge of chair, or curled in bed, tense mm, frowning, restless pacing occur with anxiety and hyperthyrodism. sitting slumped in chair, slow walking, dragging feet

Question 23

body movements

Answer 23

expected =voluntary, deliberate, coordinated, smooth and even
Unexpected= restless, fidgety mvmt or hyperkinetic appearance occurs with anxiety
* * Apathy and psychomotor slowing occur with depression and dementia

Question 24

Dress

Answer 24

expected= appropriate for setting, season, age, gender

Unexpected= inappropriate dress can occur with organic brain syndrome

[Eccentric] dress= combination and bizzare makeup occur with schizophrenia or manic syndrome

Question 25

Grooming and hygine

Answer 25

**Expected**= The person is clean and well groomed; hair is neat and clean; women have moderate or no makeup; men are shaved, or beard or mustache is well groomed **Unexpected **= unilateral neglect (total inattention to one side of the body) occurs following some strokes --poor hygiene and grooming can occur with depression and severe alzherimer disease

Question 26

Pupils

Answer 26

*note pupil size and reaction to light* **unexpected** * dilated or constricted pupils may be a sign of recent drug use. * unequal pupil size [anisoxoria] can be caused by a brain tumor

Question 27

Behavior Level of Consciousness

Answer 27

* The person is awake, alert and aware of stimuli from the environment and within the self and responds appropriately and reasonably soon to stimuli * Unexpected can occur when a person loses tract of convo, falls asleep, becomes lethargic & obunded (confused)

Question 28

Facial expression

Answer 28

* The look is appropriate to the situation and changes appropriatley with the topic. There is comfortable eye contact unless precluded by cultural norm * unexpected expression can be flat, masklike which can occur with parkinsonism and depression

Question 29

speech

Answer 29

* judge the quality of speech by noting that the person makes laryngeal sounds effortlessly and shares convo appropriately * Dysphonia is abnormal volume, pitch * Dysarthia is distored speech

Question 30

Mood and effect Behavior

Answer 30

expected=Judge by the body language and facial expression and by asking "how do you feel today" or "how do you usually feel?" The mood should be appropriate to the persons place and condition and change appropriately with topics

Question 31

orientation congnitive

Answer 31

you can discern orientation through the course of the interview by asking about the person's address, phone number and health history. or ask for it directly

Question 32

Attention span

Answer 32

Check the person's ability to concentrate by noting whether he or she completes a thought without wandering. note any distractibility or difficulty attending to you. Or give a series of direction to follow and note the correct sequence of behavhiors unexpected= digression from inital thought. irrelevant replies to question & easily distracted

Question 33

recent memory

Answer 33

can the patient recall what they are in the last 24hr? **recent memory deficit**= delirium, dementia, chronic alchoholism

Question 34

Remote memory

Answer 34

* In the context of the interview, ask the person verifiable past events (ask to describe past health, first job, birthday and anniversary dates that are relevant) * Remote memory loss is lost when the cortical storage area for that memory is damaged (alzheimer dementia or ant disease that damages the cerebral cortex)

Question 35

New learning

Answer 35

Four words test- tests the person's ability to lay down new memories. ... I am going to say four words. i want you to remember them. in a few minutes i will ask you to recall them accuracy of 3-4 words within 5-10 min is expected in those under 60. * people with Alzheimer dementia score a zero or one word recall. * impaired new learning ability also occurs with anxiety and depressio

Question 36

Thought process

Answer 36

Ask yourself, "Does this person make sense?" can i follow what the person is saying * illogical, unrealistic thought process. Digression from initial thought. ideas run together is unexpected

Question 37

Thought content

Answer 37

what the person says should be consisstent and logical * obessions, compulsions are unexpected

Question 38

perceptions

Answer 38

* The person should be consistently aware of reality. * How do other people treat you? * do other people talk about you * Do you feel as if youre being watched, followed or controlled --Illusions, hallucination are abnormal perceptions

Question 39

Mini-mental state examination

Answer 39

* simplified scored assessment of cognitive fxns * includes a brief assessment of memory, orientation to time and place, naming, reading, copying or visual-spatial orientation

Question 40

Pediatric patients and mental status assessment

Answer 40

* Focuses on the childs behavior, congiive and psychosocial development in coping with his or her environment

Question 41

denver II screening test

Answer 41

* Allows direct interaction with the young child to assess the mental status * The A,B,C,T guidelines used for adults may be used for child and adolescents taking into account developmental milestones

Question 42

older adult mental status

Answer 42

* check sensory status and correct deficits * The glasgow coma scale is a useful quantitative tool * Mini-cog- tests cognitive impairment in healthy older adults

Question 43

Depression scale

Answer 43

* 5-9 minimal symptoms * 10-14 minor symptoms * 15-19 major depression, severe

Question 44

glasgow coma scale

Answer 44

* score of 15= fully alert, normal person * score of <7= coma * can be plotted to see if patient is stable, improving or deteriorating

Question 45

Delirium

Answer 45

* acute confusional state, potentially preventable in hospitalized persons characterized by disorientation, disordered thinking and perceptions, defective memory agitation

Question 46

dementia

Answer 46

* chronic progressive loss of cognitive and intellectual functions, although perceptions and consciousness are intact. characterized by disorentation, impaired judgement, memory loss