Mental Status Assessment (Chapter 5) Flashcards
mental status is
persons emotional and cognitive functioning
optimal functioning of mental health aims toward simultaneous
life satisfaction in work, caring relationships and within self
usually mental health strikes a balance, allowing a person to function
socially and occupationally
what is a mental disorder
situation when a person has a response that is much greater than expected and is characterize by a significant behavioral or psychological pattern, that is associated by distress
what are mental disorders etiology
organic
psychiatric
when do we need to do a complete mental status exam
recent trauma resulting with a change in memory
report of decline in cognitive ability
when the patient requires a thorough exam of emotional and cognitive functioning
what are the 4 components of a mental status exam
appearance
behavior
cognition
thought processes and perceptions
what are some of the components of the mental status exam
consciousness
language
mood and affect
orientation
attention
memory
abstract reasoning
thought process
thought content
perceptions
what is included in appearance (general survey)
body movements
dress
grooming
hygiene
what is included in behavior (general survey)
level of consciousness
facial expression
speech
mood and affect
what is included in cognitive functioning (general survey)
orientation
attention span
recent memory
new learning (4 unrelated words)
what is included in thought processes (general survey)
thought content (what they say is consistent and logical)
perceptions (person should be consistently aware of reality)
suicidal thoughts
what are some examples of abnormal findings of appearance
grabbing something in pain
pacing
abnormal findings for behaviors
non responsive
in and out consciousness
laughing in inappropriate conversations
abnormal findings for thought processes and perceptions
think they are the president or its 1950
suicidal thoughts: anyone can do screening
what suicidal individual is at high risk
patients who have a plan
we want to avoid
sterotyping
difference between cognitive function and consciousness
cognition involves mental processes and propositional attitudes, such as knowledge, belief, and desire; consciousness is awareness of oneself and one’s surroundings.
sundown syndrome
a state of confusion occurring in the late afternoon and lasting into the night
dementia
multiple cognitive deficits
chronic disturbance of consciousness and cognition
long and shirt term memory loss with short term more pronounced
disturbances in executive functioning
speech and language
irreversible
delirium
acute disturbance of consciousness and cognition (develops over short period of time)
medical conditions preclude this condition
no history of dementia
may develop in addition to deminata during period of hospitalization
reversible
dementia is ______________ disturbance of consciousness and cognition
chronic
delirium is _____________ disturbance of consciousness and cognition
acute
dementia has ___________ cognitive deficits
multiple
dementia has what kind of memory loss
long and short term
what is special about dementia short term memory loss
more pronounced
what may preclude delirium
medical conditions
delirium develops over __________ period of time
short
dementia can affect the
speech and language
delirium may develop in addition ton dementia during
period of hospitalization
is dementia reversible or irreversible
irreversible
is delirium reversible or irreversible
reversible
when we have a patient with delirium due to hospital setting how might they act when they return home
become more alert and back to normal status
what does cognitive impairment look like
clouding of consciousness
impaired alertness
impaired memory (recent most common)
disoriented, language impairment
hallucinations
increased confusion at night (sundown)
agitation
glasgow coma scale determines
consciousness
levels of consciousness
alert
lethargic
obtunded
stupor/semi coma
coma
sedation scale S-4
S
asleep, easy to arouse
sedation scale S-4
1
awake and alert
sedation scale S-4
2
slightly drowsy, easily aroused
sedation scale S-4
3
frequently drowsy, arousable, drifts off to sleep during conversation
sedation scale S-4
43
somnolent, minimal or no response to physical stimulation
glasgow coma scale measures
best motor, verbal and eye response
glasgow coma scale is _____________ in nature
quantitative
glasgow coma scale below what denotes coma
8
highest glasgow coma scale
15
TIA
transischemic stroke
aphasia
difficulty speaking
3 types of aphasia
global
broca or expressive aphasia
wernicke or receptive aphasia
what is the most common type of aphasia
global
what type of aphasia is the most severe
global
global aphasia is caused by
large lesion that affects anterior and posterior language areas
how would a patient with global aphasia would present
speech is absent or only a few words
no comprehension
can’t repeat, write or read
are people with brocas/expressive aphasia able to understand
yes
are people with brocas/expressive aphasia able to express self using language
no
where is the leison brocas/expressive aphasia
motor cortex of the anterior portion of the brain (contains brocas area)
are people with brocas/expressive aphasia able to repeat or read aloud
no
are people with brocas/expressive aphasia auditory and reading comprehension intact
yes
what is the opposite of Broca aphasia
wernicke/receptive
where is the lesion for wernicke/receptive aphasia
posterior area of language center
are people with wernicke/receptive aphasia able to hear sounds
yes but they cannot relate to them
how would someone with wernicke/receptive aphasia talk
speech is fluent
patient has a great urge to speak
words are made up and frequented with word substitutions, result is incomprehensible speech
people with wernicke/receptive aphasia have imapired
repetition, reading, writing
how do we communicate with patients with broca/expressive aphasia
speak clearly
books on tape
picture board
written words
yes/no questions
email
how do we communicate with patients with wernicke/receptive aphasia
picture board
don’t keep talking and repeating
don’t write, can’t read
use gestures to help with understanding
always check what before doing a mental status assessment
sensory status (vision and hearing)
in the older adult what is slower
response time
we need to plan teaching at what pace for the older adult
slow pace
for the aging adult we need to consider if the person had multiple losses why?
because we do not want to be mid explanation/teaching and the patient does not have hearing aid or glassess
a major characteristic of dementia is
A. impairment of short and long term memory
B. Hallucinations
C. Sudden onset of symptoms
D. Substance-induced
impairment of short and long term memory
