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Nursing 202 > Neuro and Mental Health > Flashcards

Neuro and Mental Health Flashcards

1
Q

What are some factors influencing Mental Health

A

internal and emotional poblems
familial and social network
community, including health care systems, employment, and housing
Larger social issues (poverty, racism)

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2
Q

What is mental health

A

Finding a balance in all aspects of life
capacity to think, feel and express emotions and behave in ways that enhance personal capacity to manage life
sense of emotional and spiritual wellbeing

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3
Q

What is a mental disorder

A

constellations of co-occuring symptoms involvin alterations from absence of illness to maximal illness

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4
Q

Why is assessing mental health important

A

Early intervention
stigma
delay of treatment
housing difficulties
early treatment discontinuation
negative economic effect
addiction

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5
Q

Rwduce mental health stigma as providers

A

self reflect
self moniter
address own beliefs
address ow behaviours

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6
Q

Relational practices for mental health

A

respect
no judgment
reflection

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7
Q

Mental Health Nursing assesment

A

observation-manic phase?
interview
examination
physical assessment
collaboration with others

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8
Q

Mental status examination

A

emotional and cognitive functioning
domains include appearance, behaviour (mood and affect and speech, cognition (concentration, comprehension and abstract reasoning) and thinking (perception, content, process, insight, judgement)

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9
Q

Appearance for mental disorders

A

How do they look
grooming
facial expression
tremors
position
altertness
affect

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10
Q

What are their behaviours?

A

physical-pacing, crying, agitated, eye contact, withdrawn
Speech-loud, pressured, incoherant, slurred
self-care-excessive, appetite?

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11
Q

Cognition

A

orientation (time, place, person)
State of consciousness-lathergic, drowsy, alert
Mood-depressed, euphoric, labile
Memory-impaired (past/present)
Concentration (poor, good)
Judgement (impaired, good)
insight (none, limited, good)

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12
Q

thoughts

A

content-suicidal, homicidal, guilt, worthlessness, obsessions, phobias, paranoias, hallucinations, delusions

Process-coherent, logical, fleeting, tangential, attention(distracted or focused)

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13
Q

Indication for comprehensive Nursing Assessment

A

behaviour changes
brain lesions
aphasia
symptoms of psychiatric mental illness

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14
Q

Developmental considerations for mental health in adolescents

A

suicide
mental health disorders started around age 14
common disorders include depression, anxiety, ADHD, substance use
Eating disorders are also so common among Canadian Female teens

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15
Q

Mental Health assessment in adults

A

identification/biographical information
Reasons for seeking care
past health
family health hisotry
current health

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16
Q

Objective data-appearance

A

posture
body movements
dress
grooming and hygeine

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17
Q

objective data-bahviour

A

level of consciousness
facial expression
mood
affect

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18
Q

Objective data-cognitive functions

A

orientation
attention span
immediate memory
recent memory
remote memory
four unrelated word tests )additional testing for patientd with aphasia)

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19
Q

Objective data-higher intellectual functions

A

insight and judgement
thought process
thought content
perceptions

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20
Q

Supplemental Mental Status Examination

A

quick to administer
sensitivity for 90% for detecting mild cognitive impairement
good for dementia detection and delirium and difrentiationg these from psychiatric mental illness
MOCA is like the animals and shapes and fun little square drawings

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21
Q

Risk assessment

A

Suicidal thoughts
assaultive or homicdal ideation
elopement risk

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22
Q

Developmental considerations in children for mental health

A

knowledge of developmental milestones
Nipissing Developmental screen
other reliable screening tools

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23
Q

Developmental considerations for older adults and adults

A

Greater risk of alziehmers

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24
Q

CNO guideliness

A

Establishing therapeutic relations
-therapeutic communication
-client centered care
maintaining boundaries
-protecting client from abuse

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25
Neurologic assessment developmental considerations for infants
neurons are not yet myeinated
26
neurologic assessment developmental considerations for older adults
general atrophy and loss of neurons in brain and spinal cord decrease in weight and volume of brain decreased muscle strength ad impaired fine coordination slowed reaction time dizziness and loss of balance
27
Cultural and social considerations for neurologic examinations
Greater risk for heart disease and stroke intersecting factors of socio-economic factors, health care and preventative services and exercise social circumstances and ability to manage post-stroke condition importance of social resources
28
Subjective data for neurologic risks
headache head injury diziness or vertigo seizures tremors weakess incoordination numbness or tingling difficulty swallowing difficulty speaking significant past hisotry envionmental hazards medications
29
Additional neurologic examination health history questions for infants
maternal health neonatal period reflexes weakness and balance seizures physical development enviornmental hzards ognitive development family history
30
Additional health history questions
older adults risk for falls tremors vision
31
Critical findings in neurological exams
sudden changes in alterness sudden changes in speech or onset of new difficulties signs of a stroke signs of increased intracranial pressure (headaches and vommiting) sudden onset weakness, numbness, double vision seizures lathargy that persists or worsens
32
Stroke
Face-drooping? Arms-can you raise both Speech-is it slurred or jumbled Time-call 911
33
Stroke prevention
early recognition of symptoms vision changes trouble walking, dizziness, loss of balance or coordination sudden weakness sudden severe headaches (less common is vommiting, fainting)
34
Modifiable risk factors of strokes
Cardiovascular disease hypertension smoking/second hand exposure diabetes atrial fibrillation other cardiac conditions dyslipidemia asymptomatic carotid stenosis sickle cell disease postmenopausal hormone therapy diet and nutrition inactivity obesity ischemic attack history
35
immodifiable risk factors for strokes
age gender low birth weight ethnocultural background genetic factors
36
Prevention of strokes
diet limit sodium intake moderate excercis maintain healthy weight smoking cessation limit alcohol intake manage underlying health issues
37
Physical Exam for Neuro
Prep-screen neuro complete neuro exam neuro recheck exam equipment needed-penlight, tongue blade, cotton swab, cotton ball, tuning fork, percussion hammer, aromatic substances
38
Cranial Nerves
I-Olfactory II-Optic III-oculomotor IV-Trochlear VI-Abducens V-Trigeminal VII-Facial VIII-Acoustic IX-glossopharyngeal XI-spinal accessory XII-hypoglossal
39
OH OH OH To Taste and Feel Very good velvet ah heavenly
Olfactory optic oculomotor trochlear trigeminal abducens facial vestibulocochlear glossopharyngeal vagus accessory hypoglossal
40
Some say money matters but my brother says big brains matter more
correlates to order of cranial nerves
41
Olfactory
sensory-sense of smell
42
Optic nerve
sensory-visual acuity, visual fields, opthaloscope Snellen chart
43
oculomotor
pupillary, light response (motor) PERRLA eyelid droop
44
Trochlear
Motor cardinal gazes
45
Trigeminal
sensory and motor light touch to forehead (feel it) try to open mouth while clenching and palpate
46
Abduecens
motor
47
facial
sour taste on tongue smile, frown
48
acoustic
sensory whispered voice test, Weber and Rinne
49
Glossopharyngeal
Motor and sensory say ahhhh (gag reflex)
50
Vagus
motor and sensory
51
Spinal accessory
motor rotate head and shoulders against movement
52
Hypoglossal
motor say light, tight, dynamite
53
Anosmia
decrase or loss of smell from tobacco smoking, allergic rhinitis, cocaine use normal is aging decreases smell
54
When to worry with cardinal gazes
unilateral dilation non-reactivity deviation in gaze nystagmus
55
nystagmus
eye makes repetitive uncontrolled movements
56
When to worry with facial nerve
muscle weakness flattening of nasolabial fold lower eyelid sagging escape of air from only one cheeck
57
How to test acoustic cranial nerve? Vestibulocochlear
whisper test weber test rinne test
58
Cranial Nerve
motor function of the tongue
59
Objective Exam-Motor System
inspect and palpate muscles (size, strength, tone, involuntary movements) cerebellar function (balance test-gait, tandem walking, romberg test(feet together and eyes closed) Coordination and skilled movement (heel to shin test, rapid alternating movements)
60
Physical Exam-sensory system
person is alert, cooperative and comfy spinothalamic tract-pain, temp, light touch posterior column tract-vibration, position, tactile discrimination (fine touch)
61
Posterior column tract physical exam
vibration position(kinesthesia) Tactile discrimination (fine touch) sterognosis-what object in hand graphesthesia (write on hand) two point discrimination extinction point location
62
Neuro exam objective-sensory system rundown
pain-sharp vs dull light touch-cotton whisp vibration-tuning fork position sense graphesthesia-number tracing on hand stereognosis-object recognition 2 point discrimination extinction-both sides at same time point location-point to location of touch
63
objective Data-Physical Exam
test the deep tendon reflexes -technique, grading, reinforcement, biceps reflex, triceps reflex, brachioradialis reflex, quad-patellar jerk), achilles, clonus (quivering reflex)
64
What are the superficial reflexes
abdominal reflex cremastic reflex plantar reflex
65
List 4 reflexes (common
bicep tricep quadricep achilles
66
Scale for reflexes
0=absent 1=hypoactive 2=normal 3=hyperactive 4=hyperactive with clonus 5=sustained clonus
67
Developmental considerations for infants and neuro exam
spontaneuous walking activity, response to enviornment, social smile cranial nerves-cant be directly tested motor system-Nipissing District Developmental Screen Head control reflexes-plantar grasp, rooting, landau, babinski, moro, tonic neck
68
Developmental considerations for reflexes in preschool and school age children
observation of dress/undress/buttons milestones NDDS test balance, fine motor coordination sensation not reliable for testing
69
Older adult neurologcal developmental considerations for objective exam
decrease in muscle bulk snile tremors dyskineasis (difficulty with smooth movements) Difference in gait loss of ankle jerk deep tendon relfexes less brisk
70
Neurological recheck
lovel of consciousness (time, place, person) motor function pupillary response vital signs glasgow coma scale
71
Intracranial pressure signs
behavioural changes decreased level of consciousness headache (BAD) lethargy seizures vommitting
72
Glasglow Coma Scale
eye opening 4=spontaneuous 3=to sound 2=to prssure 1=no response verbal response 5=oriented 4=confused 3=words 2=sounds 1=none motor response 6=obeys 5=localizing 4=withdrawal 3=abnormal flexions 2=extension 1=none
73
GlawGlow coma scaling scoring
Mild is 13-15 Moderate is 9-12 Severe is 3-8

Nursing 202 (15 decks)

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