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Neuromuscular (KK) > arousal (A&O) mental status > Flashcards

arousal (A&O) mental status Flashcards

1
Q

if a person is A&O x4 what does that mean?

A

they are alert and oriented to person, place, time & situation

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2
Q

how do you quickly screen for memory/cognition?

A

give the patient 3 words to remember
–> retention & recall: ask patient to repeat those words back to you right away & then ask them later on to recall those 3 words

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3
Q

what are 4 things you should be sure to include in your subjective exam note?

A

behavior
language
attention
affect

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4
Q

what is level of consciousness (LOC)?

A

measurement of a person’s alertness
arousal and responsiveness to stimuli from the environment

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5
Q

alertness = _____ and _______

A

arousal and attention

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6
Q

stimulation to action or physiologic readiness for activity
level of excitability - state of responsiveness to sensory stimulation

A

arousal

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7
Q

directing of consciousness to person, thing, or environment
direction of awareness
necessary to perform conscious task

A

attention

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8
Q

state of arousal accompanied by awareness to one’s environment

A

consciousness

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9
Q

the ability to comprehend and to adjust oneself with regard to time, location, and identify of self

A

orientation

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10
Q

which level of hypoarousal is this describing?

mildly depressed level of consciousness or alertness

A

lethargic

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11
Q

which level of hypoarousal is this describing?

significantly diminished level of consciousness and cannot be fully aroused. responds to noxious stimuli and appears confused.

A

obtund

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12
Q

which level of hypoarousal is this describing?

not able to be aroused from a sleep-like state, requires vigorous unpleasant stimuli for minimal arousal

A

stupor

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13
Q

which level of hypoarousal is this describing?

unconscious, inability to make any purposeful response and no arousal

A

coma “unconscious”

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14
Q

if your patient is aroused but remains unaware of their environment and no purposeful attention or cognitive response is given but has normal respiration, digestion and BP control, what state are they in?

A

minimally conscious (vegetative) state

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15
Q

if a person is in a vegetative state for 1 year or longer after TBI or 3 months or longer after ABI, what state are they considered then?

A

persistent vegetative state

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16
Q

pt appears agitated, irritable, unable to self console, has hyperactive movement and increased intensity of voice. they are:

A

hyperaroused

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17
Q

patient is unable to attain alert state, lethargic, poor response to verbal communication and has poor processing. they are:

A

hypoaroused

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18
Q

what are some factors that affect level of arousal?

A

disease/pathology
acute change in behavior
acute change in brain chemistry

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19
Q

what three areas of function are examined to determine arousal?

A

eye opening
motor response
verbal response

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20
Q

what is the Glasgow Coma scale used for?
Low score = _______

A

outcome measure for arousal - used to document level of consciousness in acute brain injury
low score = less aroused

21
Q

what is an example of noxious stimulation in which a response would be a facial grimace?

A

sternal rub

22
Q

what is an example of noxious stimulation in which a response would be withdrawing, slight flexion or extension?

A

nailbed pressure

23
Q

what are examples of environment modifications that can be performed if a patient is hypoaroused?

A

turn on lights
decrease ambient sounds
open vs closed environment

24
Q

making environment or scheduling modifications to improve arousal

A

coping

25
Q

5 categories of attention:
1. _______ attention - process and respond to specific info.
2. _____ attention - perform an activity continuously over a period of time
3. _______ attention - focuses on one thing, perform activity with distracting stimuli
4. _______ attention - shifts focus of attention between multiple stimuli
5. ______ attention - respond to multiple stimuli simultaneously

A
  1. focused
  2. sustained
  3. selective
  4. alternating
  5. divided
26
Q

how do you test selective attention with your patient?

A

digit span task - repeat short list of numbers fwd/bkwd

27
Q

how do you test divided attention with your patient?

A

walk while counting or naming objects

28
Q

______ can play a role in attention. why?

A

behavior
intentionally distracted, obstinate behavior

29
Q

what is an outcome measure assessment for attention?

A

Moss Attention Rating Scale (MARS)
characterizes behavioral responses after brain injury

30
Q

what type of behavior matches the following definitions?
- unable to fixate
- unable to disengage
- unable to share attention between multiple tasks
- unable to manipulate new info or attend to previous info
- ability to sustain attention over time (positive sign)

A
  • distractable
  • perseverative
  • limited capacity/flexibility
  • poor recall
  • vigilance
31
Q

a patient’s “affect” is ?
mood is?

A

a collection of behaviors that describe their emotional state or mood
mood is a more sustained emotional state

32
Q

what is apathy? what is it often mistaken as?

A

shallow affect and blunted emotional responses
misconstrued as depression or poor motivation

33
Q

what is euphoria?

A

exaggerated feelings of well being

34
Q

what is social inappropriateness?

A

missed social cues or makes inappropriate comments

35
Q

what is depression?

A

poor perception of one’s self and environment may lead to increasing isolation and social withdrawal

36
Q

what is irritability?

A

changes in ability to sense, move, communicate, think or act as before are frustrating by themselves and create high stress levels for stroke patients

37
Q

what is pseudobulbar affect?

A

emotional dysregulation syndrome
characterized by emotional outbursts of uncontrolled or exaggerated laughing or crying that are inconsistent with mood

38
Q

the behavior of selecting vocabulary and sentence structures before communicating a message

A

language

39
Q

communication disorders

A

aphasia

40
Q

slurred speech

A

verbal apraxia (motor control issue)

41
Q

sound production and tone of voice

A

phonation

42
Q

taking turns talking and tangenital speech

A

pragmatic language behaviors

43
Q

sequence of words acceptable in the formation of sentence

A

syntax

44
Q

what are the 3Ds?

A

dementia (pathological condition of the mind)
delirium (impaired sensorium)
depression (low vital sense and poor attitude)

45
Q

age-associated cognitive decline is similar to _______ but NOT loss of cognition

A

dementia

46
Q

what is encephaloppathies primarily seen in?

A

alcoholism

47
Q

when chart reviewing, you notice a note in the chart to see the patient in the morning because they often exhibit increased agitation in the late afternoon/early evening. what is the reason for this & what causes it?

A

sundowning - part of dementia
causes - unknown, pharmacy, patient affect

48
Q

alcohol withdrawal delirium:
- what is it?
- when does withdrawal set in?
- symptoms peak ______ days after they begin & decrease _____ days after they begin
- appropriate for PT?

A
  • severe delirium and delusion associated with fever and other metabolic symptoms
  • 48-72 hours after last drink
  • 5 days; 5-7 days
  • no

Neuromuscular (KK) (21 decks)

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