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Nursing 6410 - Health Assessment > Mental Status Exam > Flashcards

Mental Status Exam Flashcards

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1
Q

Different LOC

A 
Level of Conciousness 
Alert
Lethargic
Obtunded 
Stupor or semi-coma 
Coma 
Delirium
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2
Q

General Survey - Physical Appearance

A

Age
Gender
Skin Color
Facial Features

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3
Q

General Survey - Body Structure

A

Posture
Position
BMI

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4
Q

General Survey - Mobility

A

Gait

ROM

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5
Q

General Survey - Behavior

A

Facial Expression

Speech

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6
Q

General Survey - Pain

A

Verbal and nonverbal

Cultural, developmental and gender considerations

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7
Q

Cerebrum

A

Primarily responsible for mental status
Divided into two hemispheres or lobes
Grey outer layer, the cerebral cortex, houses higher mental fxns and responsible for perception and behavior

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8
Q

Cerebrum - Frontal Lobe

A

Contains motor cortex associated with
Speech formation (Brocca area)
Goal-oriented behavior
Ability to concentrate and short-term behavior

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9
Q

Parietal Lobe

A

Responsible for processing sensory data

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10
Q

Temporal Lobe

A

Perception and long-term memory
Wernicke area - comprehension of written and spoken language
involved in the integration of behaior, emotion and personality

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11
Q

Limbic System

A

Certain patterns of behavior that determines survival
reactions to emotions
expressions between emotions and behavior is mediated by connections between limbic system and frontal lobe

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12
Q

Reticular Activating System (RAS)

A

in the brainstem regulates level of wakefulness or arousal

Disruption of ascending RAS can lead to altered mental status

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13
Q

Neuro. Infants and Children

A

All brain cells present at birth but first years to develop and myelinize
Brain insults such as infection, trauma, or metabolic imbalance, can damage brain cells, leading to potentially serious dysfunction in mental status

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14
Q

Adolescents - Neuro

A

Abstract thinking develops theories, logical reasoning, making future plans, generalizations, consider risks and possibilities
Judgment begins to develop with education, intelligence and experience

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15
Q

Older Adults - Neuro

A

Cognitive fxn most sensitive to aging include the speed at which new information is perceived, encoded, processed and retrieved
Minimal decline in cognitive and daily functioning should occur unless systemic or neurologic disorder develops

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16
Q

What other cognitive functions can diminish in older adults?

A

Remote memory may be more efficient than short-term
Studies suggest higher education achievement leads to better and longer-lasting cognitive function
Loss of recent memory, delayed response time and diminished ability to learn complex information may occur

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17
Q

HPI: Disorientation and Confusion

A

Onset
Associated health problems
Associated symptoms
Medications

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18
Q

HPI: Depression

A 
Troubling thoughts or feelings
low energy level 
recent changes in living situation 
SIGECAPS
Two questions for depression screening
Feel like hurting self, thoughts about dying or suicide
Medications: antidepressants
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19
Q

HPI: Anxiety

A

Sudden unexplained attacks of fear, anxiety or panic
Avoids or feels uncomfortable with people
Experienced extremely traumatic event
Associated Symptoms
DIGFAST
Medications: antidepressants, steroids, BDZ, alternative or complementary therapies

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20
Q

PMH

A

Neurologic disorder, brain surgery, brain injury, residual effects, chronic disease, or debilitating condition
Requires psychiatric therapy or hospitalization

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21
Q

Family History

A

Psychiatric disorders, mental illness, alcoholism
ALZ
Learning disorder, mental retardation, autism

22
Q

Personal and Social Hx

A

Emotional status
Life goals, attitudes, relationship with family
Intellectual level, education
Communication pattern
Changes in sleep pattern
Use of alcohol, street drugs, especially mood-altering

23
Q

Children

A 
Speech and language
Behavior 
Performance or self-care activities
Personality and behavior patterns
Learning or school difficulties
24
Q

Adolescents

A

Risk-taking behaviors
School performance and peer interactions
Family interactions, reluctance to communicate and to speak of attitudes and experience

25
Q

Older Adults

A

Changes in cognitive functioning, thought processes, and memory
Depression, somatic complaints, hopelessness, helplessness, lack of interest in personal care

26
Q

How is mental status assessed?

A 
Evaluate: 
Physical appearance and behavior
State of consciousness
Cognitive abilities
Speech and language skills
Emotional stability
27
Q

Physical Appearance and Behavior

A

Grooming: poor hygiene, lack of concern, inappropriate appearance
Emotional status: carelessness, apathy, insensitivity, docility, rage, irritability
Body language: slumped posture, lack of expression or eye contact, excessively energetic, constantly watchful

28
Q

State of Consciousness

A

Person disorientation: cerebral trauma, seizures, or amnesia
Place disorientation: psychiatric disorders, delirium, and cognitive impairment
Time disorientation: anxiety, delirium, depression, and cognitive impairment
Time is usually the first to go, followed by place then person

29
Q

Screening tests to test cognition

A

Mini-Mental State Examination (MMSE)
Mini-Cog
Three unrelated words
Clock face (clock drawing test CDT)

30
Q

Testing cognitive abilities

A

Analogies – what is similar peach and lemon, ocean and lake
Abstract reasoning – stitch in time saves nine
Arithmetic calculation – start at 100 and substract 7
Writing ability – write name and address
Execution of motor skills – comb hair
Memory – four words, repeat series of numbers
Attention span – Spell World forward and backwards
Judgment – plans for future

31
Q

When is emotional stability evaluated?

A

when the patient does not seem to be coping well or does not have resources to meet his or her needs.
Mood and feelings
Thought process and content
Perceptual distortions and hallucinations

32
Q

Depression/Sadness in Infants

A 
Levels of activity
Lethargic
Drowsy
Stuporous
Alert
Active
Irritable
33
Q

Depression in Children

A 
Types of words and speech patterns
Mood
Activity level
Preferences
Responsiveness to parent and ability to separate
Self-comforting measures
Does the child play and have fun?
Attempt memory testing at about age 4.
34
Q

Pregnant Women and Postpartum Depression

A

Risk factors for postpartum depression
History of depression
Prior postpartum depression
Depression may interfere with the mother’s attachment to the newborn and the infant’s subsequent development.

35
Q

Cognitive Decline in Older Adults

A

problem-solving skills deteriorate with age and disease.
Skills involving vocabulary and inventories of available information remain at younger adult level performance
Isaac Set Test: name 10 items in each of four groups―fruits, animals, colors, towns
Recent memory is believed to deteriorate before remote memory.

36
Q

What are some other causes of dementia/delirium/confusion?

A

Cardiovascular
Hepatic
Renal
Metabolic

37
Q

Medication effect on older adults

A 
Slow reaction times
Disorientation
Confusion
Loss of memory
Tremors
Anxiety
38
Q

Other things to assess with older adults

A

ADLs
Facial expressions and stance
masklike and dramatic
stooped and fearful

39
Q

What is a concussion?

A

An alteration in mental status resulting from a blow to the head or neck
transient disruption in the reticular neurons that maintain alertness.

40
Q

What causes a concussion?

A

Sports injuries
Motor vehicle accidents
Falls

41
Q

S/S of concussions

A 
Dizziness or dazed look
Slurred speech
Slow motor and verbal responses
Irritability
Nausea and vomiting
Loss of consciousness may indicate severe injury.
Amnesia
Deficits in coordination, memory, attention
42
Q

What causes delirium?

A 
Impaired cognition, consciousness, mood and behavioral dysfunction of acute onset
Risk factors
Serious illness
Injury
Preexisting cognitive decline
43
Q

Somatic complaints of depression

A

altered appetite, sleep problems, constipation, headache, and fatigue

44
Q

S/S of depression

A

Memory loss, poor concentration, lack of motivation, indecisiveness
Slow, sluggish speech
Delusions of worthlessness or paranoid ideation
Disorder may result from grief, reaction to medical or neurologic diseases, or change in lifestyle.

45
Q

Specific disorders of anxiety

A 
Imbalances of serotonin and NE
Panic attacks
Generalized anxiety disorder
Specific phobias
Obsessive-compulsive disorder (OCD)
Post-traumatic stress disorder (PTSD)
46
Q

S/S of anxiety

A

Palpitations, tachycardia
Sweating, shaking, trembling, choking
Chest pain or discomfort, nausea, abdominal distress
Dizziness, faintness
Feeling unreal or detached from self, “going crazy”
Paresthesias

47
Q

S/S of mental retardation in children

A

delayed motor development

delayed speech and language skills

48
Q

S/S of ADHD

A

dopamine disturbances
Short attention span
Easily distracted
Trouble completing assignments
Fidgets and squirms, moving, running, jumping
Disruptive behavior, poor impulse control

49
Q

Autistic Disorder

A

Pervasive neurodevelopmental disorder of unknown etiology
Refers to a wide spectrum of disorders typically prior to 3 years of age
Believed to have multifactorial causes and a strong genetic influence

50
Q

Dementia

A

A chronic, slowly progressive disorder of:
Failing memory
Cognitive impairment
Behavioral abnormalities
Personality changes
Often begins after 60 years of age
Usually related to structural diseases of the brain

51
Q

S/S of dementia

A

Impaired memory, forgets appointments
Getting lost in familiar areas, wandering
Unable to manage shopping, food preparation, medication, finances, and driving
Behavioral changes, inappropriate dress or conduct, impaired grooming, impulsiveness, disinhibition,
Aphasia, agnosia, apraxia
Apathy, withdrawal
Anxiety, irritability
Changes in mood

Nursing 6410 - Health Assessment (16 decks)

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