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Health Assessment > Test2-Mental Status Assessment-MJ > Flashcards

Test2-Mental Status Assessment-MJ Flashcards

1
Q

When do you do a mental health assessment?

A
  • Anxious/depressed
  • Family concerned (memory or social changes)
  • Brain injury (trauma, tumor, stroke)
  • Aphasia (difficulty speaking)
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2
Q

What does MSE stand for?

A

Mental status exam

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3
Q

What must you keep in mind when doing an MSE?

A

The MSE is only how they are acting in that one point of time. You have to continually assess

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4
Q

What does the ABC of ABC STAMP LICKER stand for?

A

Appearance
Behavior
Cooperation

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5
Q

What does the STAMP of ABC STAMP LICKER stand for?

A 
Speech
Thought
Affect
Mood
Perception
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6
Q

What does the LICKER of ABC STAMP LICKER STAND FOR?

A 
LOC
Insight and judgement
Cognitive function
Knowledge base
Endings
Reliability
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7
Q

ABC: Appearance

What should we check for here?

A
  • Posture
  • Body movement
  • Dress (appropriate clothing for weather, looking to see if it matches or if it is just usual, random pieces)
  • Grooming/hygiene
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8
Q

ABC: Behavior (general)

What are we looking for here?

A

Agitation
Hyperactivity
Psychomotor retardation

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9
Q

ABC: Behavior (specific movement)

What are we looking for here?

A
  • EPS (positive symptom)
  • Ticks (positive symptom)
  • Tremors (positive symptom)
  • Chorea (positive symptom)
  • Unchanging face (negative symptom)
  • No eye contact (negative symptom)
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10
Q

ABC: Behavior (specific movement)

What are examples of common ticks?

A

Clearing throat, blinking really hard, shouting out obscenities

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11
Q

ABC: Behavior (specific movement)

What is chorea?

A

Dance like movements

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12
Q

What is sydenhams chorea caused by?

A

Untreated strep–this will go away eventually

*strep can also cause OCD (PANDAS)

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13
Q

ABC: Cooperation

What does this mean?

A
  • The attitude toward the interviewer

- Indicates how accurate the assessment is

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14
Q

STAMP: Speech

What do we look for in speech?

A
  • Amount of speech
  • Articulation (pronunciation)
  • Modulation (volume-changes in tone)
  • Latency
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15
Q

What type of patients would have a long latency?

A

Patients with depression

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16
Q

What type of patients would have a short latency?

A

Patients with mania

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17
Q

What is pressure speech and who may talk like this?

A

Talking like words are bullets; bipolar patients

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18
Q

What type of patients have increased amount of speech?

A

Mania
Anxiety
Personality disorders
Fluent aphasias

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19
Q

What type of patients have decreased amount of speech?

A

Depression
Schizophrenia
Personality disorders
Dementia

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20
Q

What two parts of the brain are involved with speech?

A

Wernicke and Broca’s area

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21
Q

What happens if there is injury to Broca’s area?

A

You understand what is being said (Wernicke’s area), but have difficulty get the words out to respond the way you want (B)

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22
Q

What happens if there is injury to Wernicke’s area?

A

You can’t understand language (W), but can still produce the words (Broca)

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23
Q

What are the 3 types of aphasia?

A

Global, broca, and wernicke

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24
Q

Which aphasia is this: The most common and severe form. Spontaneous speech is absent or reduced to a few stereotypes words or sound

A

Global

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25
Q

Which aphasia is this: Expressive aphasia. The person can understand language but cannot express himself or herself using language

A

Broca

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26
Q

What aphasia is this: Receptive aphasia. The linguistic opposite of Broca aphasia. The person can hear sounds and words but cannot relate them to previous experiences

A

Wernicke

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27
Q

What aphasia is this: Comprehension is absent or reduced to only the person’s own name and a few select words.

A

Global

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28
Q

What aphasia is this: Characterized by confluent, dysarthria, and effortful speech. The speech is mostly nouns and verbs, with few grammatical filters, termed agrammatic.

A

Broca

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29
Q

What aphasia is this: Speech is fluent, effortless, and well articulated but has many paraphasia and made up words and often lacks substantive words

A

Wernicke

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30
Q

What aphasia is this: Repetition, reading, and writing are severely impaired. Prognosis for language recovery is poor

A

Global

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31
Q

What aphasia is this: Repetition and reading aloud are severely impaired. Auditory and reading comprehensions are surprisingly intact.

A

Broca

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32
Q

What aphasia is this: Speech can be totally incomprehensible. Often there is a great urge to speak. Repetition, reading, and writing also are impaired

A

Wernicke

33
Q

STAMP: Thought PROCESS
What are thought processes?
What kind of questions needed to be asked?

A

The way in which ideas are organized

Ask open-ended questions

34
Q

STAMP: Thought PROCESS (abnormal)

What are the 4 abnormal thought processes?

A
  • Blocking/derailment
  • Clang associations
  • Echolalia
  • Neologisms
35
Q

STAMP: Thought PROCESS
DEFINE: sudden interruption in train of thought, unable to complete sentence, seems related to strong emotion

A

Blocking/derailment

36
Q

STAMP: Thought PROCESS
DEFINE: word choice based on sound, not meaning, includes nonsense rhymes and puns

A

Clanging

*Basically rhymes that don’t make sense

37
Q

STAMP: Thought PROCESS
DEFINE: Imitation, repeats others’ words or phrases, often with a mumbling, mocking, or mechanical tone

A

Echolalia

38
Q

STAMP: Thought PROCESS
Define: coining a new word; invented word has no real meaning except for the person; may condense several words

A

Neologism

39
Q

What are the 5 ways a speaker can try and get their message across (although sometimes it doesn’t make it there)

A 
Normal thought process
Circumstantial speech
Tangental 
Flight of ideas
Loose associations
40
Q

What is a normal thought process?

A

Saying some thought and it is clearly understood by the other person

41
Q

What is circumstantial speech?

A

Talking with excessive and unnecessary detail

  • Delays reaching point
  • Sentences have a meaningful connection but are irrelevant
42
Q

Does circumstantial speech occur normally with some people?

A

Yes

43
Q

What is tangental speech?

A

Never getting to the point of the comment

44
Q

What are flight of ideas?

A

Abrupt change

  • Rapid skipping from topic to topic
  • Continuous flow of accelerated speech -Topics usually have recognizable associations or are play on words
45
Q

What are loose associations?

A
  • It is also called word salad
  • Incoherent mixture of words, phrases, and sentences
  • Illogical, disconnected, includes neologisms (a made up word)
46
Q

Which type of thought process is seen most in bipolar patients?

A

Flight of ideas

47
Q

What type of thought process is most severe?

A

Loose associations

48
Q

STAMP: Thought CONTENT
What does the client talk about?
What themes develop?

A

Let the client do most of the talking!!

49
Q

STAMP: Thought CONTENT (abnormal)

What are 4 abnormal thought contents?

A

Delusions
Overvalued ideas
Obsessions
Phobias

50
Q

STAMP: Thought CONTENT

What happens when you try and talk a patient out of a delusion?

A

Delusions are false, fixed, ideas. You can’t talk a patient out of it. Don’t argue with them! They will get VERY ANGRY!

51
Q

STAMP: Affect

What are the 8 affects?

A 
Ashamed
Angry
Anxious
Content
Happy
Interested
Surprised
Sad
52
Q

What is the difference between affect and mood?

A

Affect is OBJECTIVE; it is what we see in them

Mood is SUBJECTIVE; we have to ask something along the lines of “how do you feel today?” to be able to determine their mood

53
Q

STAMP: Affect

What are the 3 “other descriptions” for affect?

A

Appropriate/inappropriate (talking about death and giggling=inappropriate)

Blunted or flat (expressionless face)

Labile (changes a lot and quickly; these are dangerous patients)

54
Q

STAMP: Mood

How do you determine this?

A

This is the clients own stated emotional state

55
Q

STAMP: Perceptions

What are the 4 examples of perceptions?

A

Hallucinations
Illusions
Depersonalization
Derealization

56
Q

STAMP: Perceptions

What are hallucinations?

A

Something that comes from nothing

57
Q

STAMP: Perceptions

Are hallucinations only in some of the senses or in all of them?

A

ALL

58
Q

STAMP: Perceptions

What are illusions?

A

See something but are mistaking it for something else

EX: Patient sees a coat stand and thinks it is some man standing with a gun

59
Q

STAMP: Perceptions

What is depersonalization?

A

When you don’t feel real

60
Q

STAMP: Perceptions

What is derealization?

A

You don’t feel as if the world around you is real

61
Q

LICKER: LOC

What do we look for during LOC?

A

If the patient is alert, awake, and aware
Do they loose track of conversation
Are they falling asleep?

62
Q

LICKER: LOC

What are the 5 LOC from most alert to least alert?

A
  1. Alert
  2. Lethargic
  3. Obtunded
  4. Stupor or semi-coma
  5. Coma
63
Q

LICKER: LOC
Define: Not fully alert, drifts off to sleep when not stimulated; can be aroused to name when called in normal voice but looks drowsy; responds appropriately to questions or commands but thinking seems slow and fuzzy; inattentive; looses train of thought; spontaneous movements are decreased

A

Lethargic

64
Q

LICKER: LOC
Define: Sleeps most of the time; difficult to arouse (needs shout or vigorous shake); acts confused when aroused; converses in monosyllables; speech may be mumbled and incoherent; requires constant stimulation for even marginal cooperation

A

Obtunded (transitional state between lethargy and stupor)

65
Q

LICKER: LOC
Define: Spontaneously unconscious responds only to persistent and vigorous shake; has appropriate motor responses; otherwise can only groan, mumble, or move restlessly; reflex activity persists

A

Stupor or semi-coma

66
Q

LICKER: Insight and judgement

What is insight?

A

Having awareness of one’s illness

67
Q

LICKER: Insight and judgement

What is judgement?

A

Ability to evaluate options and make appropriate decisions

  • Can be difficult to assess
  • Ask questions like “what do you plan to do after you get out of this [mental] institute?
  • Answering poorly indicated poor judgement
68
Q

LICKER: Cognitive functioning

There are many tests that can be done to determine cognitive functioning, but one is the most important. What is it?

A

Short term memory-4 word recall

69
Q

LICKER: Cognitive functioning

Describe the short term memory-4 word recall

A
  • Highly sensitive and valid memory test
  • Say to the person, “I am going to say 4 words. I want you to remember them. In a few minutes I will ask you to recall them.”
  • Ask them to recall after FIVE MIN.
  • To test duration of memory, ask them to recall at TEN MIN and THIRTY MIN
70
Q

LICKER: Knowledge base

What is important here?

A

Knowing level of education and vocabulary of the patient

71
Q

LICKER: Endings

What questions are important to ask at this step?

A

If there is any suicidal ideation or homicidal ideation

72
Q

LICKER: Reliability

What is this?

A

The summary of quality of MSE

73
Q

True or false: the aging adult decreases in knowledge and intelligence

A

FALSE; the aging adult does NOT decrease in knowledge and intelligence–>there may be a decrease in response times as aging occurs

74
Q

When you are doing a LOC test, if a patient isn’t for sure on the right date it is, does that mean they are losing their consciousness?

A

No. Many times in the hospital dates and times just pass by. Use your judgement here

75
Q

Dementia or delirium: slow chronic and irreversible; loosing your mind

A

Dementia

76
Q

What is the most common form of dementia?

A

Alzheimer’s

77
Q

Dementia or delirium: acute, sudden, reversible

A

Delirium

78
Q

Is a mini-cog a sensitive or specific test?

A

It is BOTH a sensitive AND specific test

Health Assessment (26 decks)

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