module 23 assessment of mental health

Question 1

mental status definition

Answer 1

total expression of a persons emotional responses, mood, cognitive functioning, and personality
- can vary at different parts of life span

Question 2

disorientation and confusion

Answer 2

onset
associated health problems
associated symptoms
medications

Question 3

depression

Answer 3

troubling thoughts or feelings: what thoughts?
low energy level
recent changes in living situation: divorce, loss
feels like hurting self, thoughts about dying
medications: antidepressants

Question 4

anxiety

Answer 4

organic or psychological
sudden unexplained attacks of fear, anxiety, or panic
uncomfortable with peaople
experienced trauma
associated symptoms
medications
- antidepressants, steroids, benzodiazepines, OTC, herbal

Question 5

mental health PMH

Answer 5

neurologic disorder
brain surgery
brain injury
residual effects
chronic disease
 debilitating condition 
psychiatric therapy or hospitalization

Question 6

mental health personal and social hx

Answer 6

emotional status 
life goals, attitudes, relationships
education, intellectual level
communication patterns
hospitalizatoins
use of alcohol or drugs, mood altering drugs
- cage questionnaire 
hx of suicide attempt
domestic abuse

Question 7

family hx

Answer 7

psych disorders
mental illness
alcoholism
drug abuse
alzheimers
learning disorders
mental delay 
autism 
bipolar: 7-fold in family

Question 8

children

Answer 8

speech and language
behavior 
performance of ADL 
personality and behavior patterns 
learning difficulties

Question 9

adolescents

Answer 9

risk-taking behavior
school performance
peer interaction
family interaction: multiple homes?

Question 10

preg women

Answer 10

hx of alcohol or drugs

depression/anxiety

Question 11

older adults

Answer 11

changes in cognitive functioning, thought processes, and memory 
depression 
somatic complaints
hopelessness
lack of interest in personal care
well groomed?

Question 12

exam and findings

Answer 12

assessed throughout the physical exam 
- appearance and behavior
state of consciousness
cognitive abilities
speech and language skills
emotional stability

Question 13

appearance and behavior

Answer 13

grooming: poor hygiene, lack of concern
emotional status: carelessness, apathy, rage, irritable
Body language: slumped, lack of expression/eye contact, excessively energetic, constantly watchful

Question 14

state of consciousness: person disorientation

Answer 14

cerebral trauma
seizures
amnesia

Question 15

state of consciousness: place disorientation

Answer 15

psychiatric disorders
delirium
cognitive impairment

Question 16

state of consciousness: time disorientation

Answer 16

anxiety
delirium
depression
cognitive impairment

Question 17

cognitive abilities exam

Answer 17

Mini-mental state examination (MMSE)

• analogies
• abstract reasoning
• arithmetic calculation
• writing ability
• execution of motor skills
• memory
• attention span
• judgement

Question 18

speech and language skills

Answer 18

voice quality
articulation
comprehension
coherence
aphasia

Question 19

emotional stability

Answer 19

evaluated when the pt 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

Question 20

infants

Answer 20

level of activity
- lethargic
- drowsy
- alert
- active
- irritable 
Responsiveness to environmental stimuli 
- smile
- caregiver depression 
Crying and other vocal sounds

Question 21

children

Answer 21

types of words and speech patterns 
mood
activity level 
responsiveness to parent, ability to separate 
self-comforting measures 
attempt memory testing at age 4

Question 22

pregnant women

Answer 22

prevalence of depression during preg and postpartum:
- 10-15%
postpartum bluse: 50-80%
risk factors for PPD
- hx of depression
- prior PPD
may interfere with the mothers attachment to the newborn and the infants subsequent development

Question 23

older adults test

Answer 23

Isaac Set Test
- evaluated mental function as a whole in about 5 min
recent memory for important events and conversations not usually impaired
- recent memory is believed to deteriorate before remote memory

Question 24

older adults other causes of cerebral dysfunction

Answer 24

CV
hepatic
renal 
metabolic
medications

Question 25

older adults changes in cognation

Answer 25

review ability to perform ADL
older adults expected to maintain the same level of
interpersonal skills and have to personality changes
facial expression and stance
- mask-like or dramatic
- stooped and fearful