Mental Status Ch. 5 Flashcards
Define Mental Status
A person’s emotional and cognitive functioning
usually strikes a balance between good and bad days
What is an organic mental disorder?
Something that appears for no apparent reason
What kind of things affect aging adults’ mental status?
Grief, fear of dying, surrounding loss
What are the components of the mental status examination?
ABCT
Appearance
Behavior
Cognition
Thought Processes
When is a full mental status examination necessary?
Symptoms of psychiatric mental illness
Initial screening suggests disorder
Behavior changes/memory loss
Brain lesions
Aphasia
What are some factors that could affect interpretation of mental status exam results?
Known illness/health problems
Medications
Educational/Behavioral level
Stress Response
What kind of things are noticed in the Appearance during a mental status exam?
Posture
Body movements
Dress
Grooming/Hygiene
What kind of things are noticed in the Behavior during a mental status exam?
LOC
Facial Expression
Speech
Mood/Affect
What kind of things are noticed in the Cognitive section of a mental status exam?
Orientation
Judgement
Attention span
recent/remote memory
How is orientation assessed in the mental status exam?
Asking patient for:
Time (date, month, season, etc)
Place (where they live, are, state, building)
Person (who they are, what they do)
Situation (why they’re here)
What aspect of orientation is often lacking in hospital patients despite being fully oriented in other areas?
Time
ICU patients might not know what day/time it is due to disrupted sleep/wake cycle
What is the Four Unrelated Words Test?
Highly sensitive/valid memory test
give the patient 4 unrelated words and ask them to remember them
ask the patient to recall the words at 5, 10, and 30 minutes
Define Aphasia
The loss of ability to speak or write coherently or to understand speech/writing
often due to a stroke
What is the ability to compare and evaluate alternative and reach an appropriate course of action?
Judgement
What is the scale used for anxiety screening?
GAD-7
Generalized Anxiety Disorder Scale
What are the scales for Depression screening?
Patient health questionnaire 2: PHQ-2 (shorter test)
PHQ-9: longer/more detailed test
What types of questions are asked in a PHQ-2 or PHQ-9?
How often are any of the following bothering you?
-little interest/pleasure in doing things
-feeling down/hopeless/depressed
-tired/little energy
-feeling bad about yourself
-moving slowly
-thoughts about hurting yourself
What types of questions are asked in a GAD-7?
How often are any of the following bothering you?
-feeling nervous, anxious, or on edge
-trouble relaxing
-restless/unable to sit still
-easily annoyed/irritable
-afraid something awful might happen
What are the 3 steps of screening for suicidal thoughts?
- Assess for possible harm risk if they express sadness, hopelessness, despair, or grief
- Begin with more general questions and proceed if given affirmative answers
- Share any concerns you have about their suicidal ideation with a mental health professional
What is an example of a supplemental metal status exam?
Mini-Med Status Exam
Explain what a Mini-Med Status Exam is
MMSE
concentrates only on cognitive functioning, not on mood or thought process.
What types of questions are asked on a MMSE?
Asking the patient orientation questions, their ability to do basic math, recall test, language expression, copying a shape
Explain the difference between dementia and delirium
DEMENTIA:
-irreversible cognitive impairment and short-term memory loss related to an organic brain disease (usually alzheimer’s or cerebral infarcts)
DELIRIUM:
-Temporary confusion usually related to another medical condition, medications, or change in environment (ICU confusion)
What should be assessed in an aging adult first regarding mental status?
Sensory status, vision, and hearing FIRST
move on to ABCT test if their is additional concerns
Assess behavior with the Glasgow Coma Scale
Assess cognitive functioning, such as orientation and a Mini-Cog
What does a Mini-Cog test consist of? Who is it used for?
It is a supplemental mental status test for healthy adults. Consists of a three-item recall test and a clock-drawing test
What are some abnormal findings possible in a mental status exam?
Altered LOC (unsure of time, person, place, or situation)
Mood & Affect abnormalities
Anxiety disorders
Delirium, dementia, depression
