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PMHNP > MSE & delirium/delusion > Flashcards

MSE & delirium/delusion Flashcards

1
Q

Delusion

A

A false belief firmly maintained despite evidence to the contrary

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2
Q

Referential thinking

A

patients believe that the information they see or hear is meant directly for them

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3
Q

Components of mental status exam (5)

A

Appearance
behavior
speech
mood
affect
Thought process

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4
Q

Thought process is:

A

the assessment of the organization of the patient’s thoughts and ideas

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5
Q

Normal thought processes can be documented as (4)

A

logical, linear, coherent, goal oriented

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6
Q

Abnormal thought processes can be documented by as (3)

A

associations are not clear, organized, or coherent

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7
Q

Tangentiality

A

moves from thought to thought that may or may not relate in some way but NEVER gets to the point

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8
Q

Circumstantial

A

Provides unnecessary detail but eventually gets to the point (C- like circle)

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9
Q

Thought content:

A

refers to the themes that occupy the patient’s thoughts and perceptual disturbances

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10
Q

Examples of thought content: (3)

A

SI, HI, plan, visual hallucination, auditory hallucinations

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11
Q

Insight:

A

refers to the patient’s awareness and understanding of their own thoughts, feelings, behaviors, and presence of any mental health symptoms or conditions

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12
Q

Assessment for insight:

A

Insight is assessed by exploring the patient’s awareness of their mental health condition, including the ability to recognize their symptoms, acknowledge the need for treatment, and understand the impact of their conditions on their life. Exp: Do you believe you have a mental health condition and might need medications? Do you understand why you are taking medication or attending therapy sessions?

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13
Q

Judgement:

A

refers to the ability of the patient to make sound decisions evaluate the situation and anticipate the consequences of their actions based on social norms, cultural values, and personal goals

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14
Q

Assessment for judgement:

A

Judgment is typically evaluated through questions or hypothetical scenarios that assess the patient’s ability to weigh options, consider alternatives, and choose the most appropriate course of action
exp: what would you do if you found a wallet on the street? How would you handle a disagreement with a friend or family member?

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15
Q

Folsetin scale (MMSE)

A

quantitative evaluation of cognitive impairment and records cognitive changes over time in adults
can screen for dementia and measure progression over time

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16
Q

Assess for concentration/attention/calculation:

A

I would like you to count backward from 100 by sevens or do serial 7s or subtract seven from 100, or list all 12 months in reverse order

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17
Q

Assessment for orientation:

A

what is the year? season? Date? Day? month? Where are we now?

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18
Q

Registration and ability to learn new material:

A

Say the names of three unrelated objects clearly and slowly, allowing one second for each. after you say them, have the patient repeat back

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19
Q

Recall (memory)

A

Ask the patient if he or she can recall the three words you previously asked hin or her to remember *after 5 min

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20
Q

Fund of knowledge:

A

who is the president/governor

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21
Q

Other instruments for assessing level of cognition impairment (pg 281) (3)

A

Montreal Cognitive Assessment (MoCA)
Mini-cog
St. Louis university mental status examination (SLUM)

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22
Q

Risk factors for SI (12) pg. 163

A

Previous SI attempt
age 45 or older if male
age 55 or older if female
divorced, single, separated
white (caucasian)
living alone
Psychiatric disorder
physical illness
substance abuse
family hx of SI
recent loss
male gender

23
Q

Normal range on MMSE

A

25-30

24
Q

Mild cognitive impairment range MMSE

A

21-24

25
Q

Moderate middle stage on MMSE

A

10-20

26
Q

Severe late stage alzheimers MMSE

A

0-9

27
Q

Mild range for SLUM (0-30)

A

21-26

28
Q

Mild range for MoCA

A

18-25

29
Q

PHQ-9 rates what? what is the moderate scale?

A

Depression
10-14 moderate

30
Q

HAM D rates what? Moderate scale?

A

Depression/Anxiety 14-18

31
Q

Beck rates what? moderate?

A

Depression
19-29

32
Q

GAD moderate score

A

10-14

33
Q

when someone has mild to moderate depression what is the intervention?

A

therapy/nothing

34
Q

When someone has moderate and severe anxiety depression, the intervention is

A

medications and or therapy

35
Q

If scoring on the depression scale fall on severe range intervention is

A

assess SI

36
Q

Delirium (6)

A

acute onset, altered LOC, inattention, confusion, changes in cognition, poor prognosis

37
Q

Delirium Prognosis

A

One year mortality rate is up to 40%

38
Q

Treatment for delirium

A

antipsychotic agents

39
Q

Best for agitated delirious

A

Haldol

40
Q

Alcohol induced delirium tx choice

A

benzodiazepines

41
Q

Tx for delirium and antispychotics

A

anxiolytics

42
Q

non-pharmacological interventions for delirium (3)

A

safety needs fall risk
basic needs
familiarity in the room familiar person or photos

43
Q

MSE for a preschooler you want to? (3-5yo)

A

listen and observe clues (dependent on clinical observation)

44
Q

constructional apraxia and caused by

A

inability or difficulty to build, assemble, or draw objects

can be caused by lesions in parietal lobe after stroke or with Alzheimer

45
Q

Stereognostic exam (stereognosis testing)

A

neurological assessment used to evaluate a person’s ability to recognize and identify objects by touch alone

46
Q

stereognosis testing assess the integrity of ________

A

sensory pathways and processing in the brain esp in the parietal lobe which plays a role in somatosensory perception and spacial awareness

47
Q

Dementia

A

group of disorders characterized by gradual development of multiple cognitive deficits

48
Q

Progressive mental decline

A

dementia

49
Q

irritability and personality changes is seen in

A

dementia

50
Q

what vitamin levels should you check with dementia

A

b12 and folic acid

51
Q

What can cause delirium in older adult patients that would not be noticed right away

A

infections such as UTIs

52
Q

elderly comes in very confused, delirious, agitated what do you want to order to check for ? esp for elderly women

A

UA with culture and sensitivity

53
Q
A

PMHNP (46 decks)

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