Mental Status Flashcards
definition of MENTAL STATUS
- ability of COGNITIVE FUNCTIONING;
- ability of EMOTIONAL FUNCTIONING
- ability of CEREBRAL FUNCTION
- ability to cope with STRESS
describe MENTAL STATUS EXAMINATION
- observing PHYSICAL APPERANCE & BEHAVIOR
- how do they RESPOND?
- are they PAYING ATTENTION?
- are they EMOTIONALLY STABLE?
- how is their SPEECH/LANGUAGE?
cerebrum
- primarily responsible for a person’s mental status
- composed of TWO CEREBRAL HEMISPHERES that have lobes
limbic system
- important for mediation of survival patterns of behavior (aggression, mating, fear, & affection)
- regulates emotions; anger, love, hostility, envy
- memory consolidation
reticular system
- regulates VITAL REFLEXES - heart & respiratory functioning
- maintains wakefulness & awareness & arousal functions
frontal lobe
- contains motor cortex / speech formation (BROCA AREA)
- important for decision making, problem solving, concentration, & short-term memory
parietal lobe
responsible for receiving & processing sensory data
temporal lobe
- responsible for perception & interpretation of SOUNDS - localizing their source
- contains WERNICKE AREA - allows one to understand spoken & written language
- long-term memory
describe MENTAL STATUS OF OLDER ADULTS
- declining of executive functions
- declining of psychomotor speed
- still have stable verbal skills/knowledge
disorientation & confusion
- can be either INTERMITTENT, FLUCTUATING, OR PERSISTENT
- can have more associated health problems
- impairments in hearing or vision
- neurologic disorders
- can be caused by MEDICATIONS, have mood swings, delusions etc…
depression
- Feelings of sadness, loss, anger, or frustration that
interfere with everyday life for an extended period
can have TROUBLING THOUGHTS OR FEELINGS
- LOWER ENERGY LEVELS + FATIGUE
- can be associated with recent CHANGES IN LIFE
- THOUGHTS OR PLANS OF HURTING SELF OR OTHERS
- medications;
- antidepressants, antihypertensive agents, corticosteroids etc…
anxiety
- have SUDDEN AND UNEXPLAINED EPISODES of INTENSE FEAR OT WORRY
- feeling UNCOMFORTABLE OR AVOIDING SITUATIONS
- having PANIC ATTACKS, or OBSESSIVE/COMPULSIVE BEHAVIORS
- medications;
- antidepressants, steroids, benzodiazepines
what are some important PATIENT HISTORIES to consider for mental status?
FAMILY HISTORY;
history of mental illness, disorders, autism etc…
PERSONAL & SOCIAL HISTORY;
status of emotion, life goals, economic factors, alcohol/drugs etc…
can mental status also be assessed through PHYSICAL EXAMINATION?
yes!
- important to look at;
GROOMING
are they appropriate?
is their hygiene concerning?
EMOTIONAL STATUS
how is their mood?
BODY LANGUAGE
how is their posture, expression, or energy?
how is state of consciousness assessed?
looking for ALERTNESS & ORIENTED
- must be ORIENTED to PERSON, PLACE and TIME
meaning of A&O x3 / A&O x4
A&O x3
- aware of person, place, & time
A&O x4
- aware of person, place, time, & reasonpe
person disorientation
can be caused by;
- CEREBRAL TRAUMA
- SEIZURES
- AMNESIA
time disorientation
can be caused by;
- ANXIETY
- DELIRIUM
- DEPRESSION
- COGNITIVE IMPAIRMENT
place disorientation
can be caused by;
- PSYCHIATRIC DISORDERS
- DELIRIUM
- COGNITIVE IMPAIR MENT
what are some signs of COGNITIVE IMPAIRMENT?
- high memory loss
- confused
- impaired comms.
- inappropriate affect
- agitation/sus
what are the SCREENING TESTS to assess COGNITION?
- MINI-MENTAL STATE EXAMINATION (MMSE)
- MINI-COG
describe the MMSE
- often used for OLDER ADULTS
- tests for time orientation, remembering 3 words, and naming common objects
- following directions
describe the MINI-COG
- helps to assess impairment in OLDER ADULTS
- type of three-item RECALL TEST for memory/clock drawing test
what are our COGNITIVE ABILITIES (7)?
- ABSTRACT REASONING
proverb/metaphor - ARITHMETIC CALC
- WRITING ABILITY
name/address - MOTOR SKILLS
- MEMORY
- ATTENTION SPAN
- JUDGEMENT
hypothetical situations/future plans
recent memory
asking patient to view 4-5 test objects & to recall them in a few minutes
remote memory
asking patient to verify past events in their life
aphasia
the inabilty to speak
what are the expectations in terms of normal SPEECH & LANGUAGE SKILLS?
- proper inflections
- clear & strong
- able to increase in volume
- proper COHERENCE/COMPREHENSION
circumlocution
substitution of a word to avoid revealing word was forgotten
clang association
word choice based on sound - nonsensical way
perservation vs. echolalia
repetitive phrases / repeats another person’s words
describe the GLASGOW COMA SCALE
- type of OBJECTIVE TOOL
- assesses the CEREBRAL FXN and BRAINSTEM
has three divided sections;
- EYE OPENING RESPONSE
- BEST VERBAL RESPONSE
- BEST MOTOR RESPONSE
NORMAL SCORE IS = 15
ABNORMAL SCORE/COMATOSE = 7 OR LESS
UNRESPONSIVE = 3 OR LESS
alert
awake or easily aroused
lethargic/somnolent
- not FULLY ALERT
- drifts off to sleep
- inattentive
obtunded
- difficult to arouse
- must be SHAKED or SHOUTED AT
- sleeps most of the time
stupor / semi-coma
roused only with PAIN or PERSISTENT SHAKING
- grumbles or moans
coma
completely unconscious
traumatic brain injury - Concussion
direct blow to HEAD OR FACE - causes BRUISES to the brain
- causes INFLAMMATION
symptoms of concussion
- dazed expression
- slurred speech
- nausea/vomiting
- loss of consciousness
- slow motor/verbal responses
mania
Persistently elevated, expansive, euphoric, or irritable mood lasting longer than 1 week; one phase of the bipolar disorder
schizophrenia
A severe, persistent, psychotic syndrome with relapses throughout life
- often has hallucinations of impaired reality/often a type of genetic disorder
delirium
an IMPAIRED CONDITION–cases of behavioral dysfunction/consciousness
- often caused by MEDICATION/DISEASE, is often REVERSIBILE
dementia
type of CHRONIC SLOW PROGRESSIVE DISORDER of failing memory, personality changes, etc…
- often IRREVERSIBLE
aphasia
language problems
apraxia
organizational problems
agnosia
unable to recognize objects or purpose
