CH 5: Mental Status

Question 1

mental status is?

Answer 1

emotional and cognitive functioning

Question 2

optional function aims toward?

Answer 2

simultaneous life w satisfaction in work, caring relationships, and within self
*influenced by environmental, biological, and sociodemographic factors

Question 3

mental disorder?

Answer 3

clinically significant behavioral/emotional/cognitive syndrome associated w distress, distress, or disability involving social, occupational, or key activities
a response much greater than expected
*anxiety, stress, depression

Question 4

organic disorders?

Answer 4

brain disease of known specific organic cause (delirium, dementia, alcohol/drug intoxication, withdrawal) anything that metabolically affects brain

Question 5

psychiatric mental illness?

Answer 5

etiology not established, dysfunction affecting self care in everyday life
*schizophrenic, GAD

Question 6

when to complete mental status exam?

Answer 6

recent trauma resulting with a change in memory
report of cognitive ability decline
when emotional and cognitive functioning is required

Question 7

mental status exam components?

Answer 7

less comprehensive, done during course of physical exam- ABCT
A- appearance
B- behavior
C- cognition
T- thought processes and perceptions

Question 8

components of mental status exam?

Answer 8

consciousness
language
mood and affect
orientation
attention
memory
abstract reasoning
thought process
thought content
perceptions

Question 9

GAD-7?

Answer 9

7 itemized scales
higher the score, greater the likelihood
first 2 questions relate to core anxiety
greater or equal than 3 = diagnosis

Question 10

depression screening?

Answer 10

Patient Health Questionnaire-2 (PHQ2): 2 questions about depressed mood and anhedonia (lack of interest), screening tool to use full PHQ-9
PHQ-9: 9 questions adding column totals relating to frequency of occurrence of symptoms, higher the score=greater the likelihood of functional impairment or clinical diagnosis

Question 11

what does cognitive impairment look like?

Answer 11

clouding of consciousness
impaired alterness
impaired memory (recent most common)
disoriented, language impairment
hallucinations
increased confusion at night
agitation

Question 12

delirium?

Answer 12

acute disturbance of consciousness and cognition (develops over short period of time)
medical conditions preclude it
no history of dementia
may develop in addition to dementia
*experienced by older adults who develop UTIs (metabolic imbalance)
characterized by rapid emotional changes

Question 13

dementia

Answer 13

multiple cognitive deficits
chronic disturbance of consciousness and cognition
long and short term memory loss, short term more pronounced
disturbances in executive functioning
speech/language disturbances

Question 14

level of consciousness?

Answer 14

describes awareness and understanding of what is happening in his or her surroundings
A&O x 3 or 4
awareness-
-awake: interactive
-lethargic: sleepy, drowsy, rousable/responsive
-stuporous: arousable WITH stimuli, resists arousal
-obtunded: cannot maintain arousal w/o repeated stimuli, moans/groans to stimuli
-comatose: non interactive w surroundings
orientation-
-person
-place
-time
-situations

Question 15

sedation scale?

Answer 15

S= asleep, easy to arouse
1= awake and alert
2= slightly drowsy, easily aroused
3= frequently drowsy, arousable, drifts off to sleep during conversation
4= somnolent, minimal or no response to physical stimulation

Question 16

Glasgow coma scale?

Answer 16

measures best motor, verbal, and eye response
determinate of level of consciousness
quantitative of level of consciousness
valid and reliable
score of <8 denotes coma
best response: 15
comatose: 8 or less
totally unresponsive: 3

Question 17

global aphasia?

Answer 17

most common, most severe
causes lesion that affects anterior and posterior language areas
speech is absent/few words
no comprehension
cant repeat, read, or write

Question 18

Broca’s or expressive aphasia

Answer 18

able to understand
cant express self using language
cant repeat or read aloud
lesion is in the motor cortex of the anterior portion of the brain (broca)
can read, listen, and understand but cannot express

Question 19

how should you communicate with pt who has wernicke?

Answer 19

picture board
do not keep talking and repeating
do not write
use gestures to help understanding

Question 19

Wernicke or receptive aphasia

Answer 19

opposite of Broca, posterior area of language center
can hear sounds- can’t relate to them
speech is fluent, urge to speak but words are made up= incomprehensible speech
impaired repetition, reading, writing
speaks but does not make sense

Question 19

communicating with broca?

Answer 19

speak clearly
books on tape
picture board
written word (yours AND theirs) can read and understand it
yes/no questions
email

Question 20

mini mental status exam?

Answer 20

tool used to systematically and thoroughly assess mental status, measures 6 areas of mental abilities:
orientation to time and place
knowing the date and where you are
attention/concentration
short term memory (recall)

Question 21

what is the mini mental status exam used for?

Answer 21

to assess patient’s cognitive status when there is a concern of cognitive impairment. MMSE is sensitive and specific in detecting DELIRIUM and DEMENTIA in patients at a general hospital and in residents of long-term facilities

Question 22

the aging adult?

Answer 22

get baseline on admission (ABCT)
check sensory status before mental status assessment (vision and hearing)
normally no decrease in knowledge or loss of vocab

slower response time
don’t answer for patient
teach at slower pace