Mental status assessment Flashcards
(24 cards)
Assessment in a full mental exam
- physical appearance/behavior
- cognitive abilities
- emotional stability
- speech and language skills
- alertness and orientation
Things to look for with physical appearance and behavior
- Grooming - dressed appropriately, hygiene
- Behavior - cooperative vs hostile, apathetic, irritability
- Nonverbal communication
Order of A & O
- Person
- Place
- Time
- Purpose (sometimes event)
Things to look for with cognitive abilities
How does the patient respond to questions. Can they perform tasks. (i.e. memory loss, confusion)
How is cognitive ability assessed
Mini-mental state exam
What are the 5 things that a mini-mental state tests for
- Orientation
- Registration
- Attention and calculation
- Recall
- Language
What is the maximum score for a mini-mental
30
What does a score of 20 or less (but no more than 26) on a mini-mental indicate
Dimentia
Types of cognitive abilities
- analogies
- Abstract reasoning
- Math
- Writing
- Motor skills
- Memory
- Attention span
- Judgment
Things to look for with speech and language skills
- Assessment of receptive and expressive speech
- Voice quality - pitch, pattern, difficulty
- Articulation
- Comprehension - follows instruction
- Coherence - “word salad”
Things to look for with emotional stability
- Mood/feelings - irritable, happy, sad, angry
- Logical thought process
- Hallucinations or distortions
Why do you do the MMSE frequently and over time
It can show degeneration. Scored out of 30
What is considered mild impairment with the MMSE
21-25
What is considered moderate impairment with MMSE
11-20
What is considered severe deficit with MMSE
0-10
Apraxia
Inability to complete a task to due poor functioning motor skills
Two types of memory (during cognitive ability)
- Recent memory
2. Remote memory
Recent memory
ask pt to repeat 3 items, then have them repeat it in a few mins
Remote memory
Ask about verifiable facts (maiden name, high school, birth place)
Which type of memory is still intact with alzheimers
Remote memory
Attention span
Have pt repeat a phrase or short story
Aphasia
Absence or impairment of speech
Wernickes aphasia
Fluent, rapid speech but sentences lack meaning
Brocas aphasia
Nonfluent, slow, few words, inflection impaired, but the words are meaningful
