module 23 assessment of mental health Flashcards
mental status definition
total expression of a persons emotional responses, mood, cognitive functioning, and personality
- can vary at different parts of life span
disorientation and confusion
onset
associated health problems
associated symptoms
medications
depression
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
anxiety
organic or psychological
sudden unexplained attacks of fear, anxiety, or panic
uncomfortable with peaople
experienced trauma
associated symptoms
medications
- antidepressants, steroids, benzodiazepines, OTC, herbal
mental health PMH
neurologic disorder brain surgery brain injury residual effects chronic disease debilitating condition psychiatric therapy or hospitalization
mental health personal and social hx
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
family hx
psych disorders mental illness alcoholism drug abuse alzheimers learning disorders mental delay autism bipolar: 7-fold in family
children
speech and language behavior performance of ADL personality and behavior patterns learning difficulties
adolescents
risk-taking behavior
school performance
peer interaction
family interaction: multiple homes?
preg women
hx of alcohol or drugs
depression/anxiety
older adults
changes in cognitive functioning, thought processes, and memory depression somatic complaints hopelessness lack of interest in personal care well groomed?
exam and findings
assessed throughout the physical exam - appearance and behavior state of consciousness cognitive abilities speech and language skills emotional stability
appearance and behavior
grooming: poor hygiene, lack of concern
emotional status: carelessness, apathy, rage, irritable
Body language: slumped, lack of expression/eye contact, excessively energetic, constantly watchful
state of consciousness: person disorientation
cerebral trauma
seizures
amnesia
state of consciousness: place disorientation
psychiatric disorders
delirium
cognitive impairment
state of consciousness: time disorientation
anxiety
delirium
depression
cognitive impairment
cognitive abilities exam
Mini-mental state examination (MMSE)
- analogies
- abstract reasoning
- arithmetic calculation
- writing ability
- execution of motor skills
- memory
- attention span
- judgement
speech and language skills
voice quality articulation comprehension coherence aphasia
emotional stability
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
infants
level of activity - lethargic - drowsy - alert - active - irritable Responsiveness to environmental stimuli - smile - caregiver depression Crying and other vocal sounds
children
types of words and speech patterns mood activity level responsiveness to parent, ability to separate self-comforting measures attempt memory testing at age 4
pregnant women
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
older adults test
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
older adults other causes of cerebral dysfunction
CV hepatic renal metabolic medications
older adults changes in cognation
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
