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Nursing 202 > Neuro and Mental Health > Flashcards

Neuro and Mental Health Flashcards

1
Q

What are some factors influencing Mental Health

A

internal and emotional poblems
familial and social network
community, including health care systems, employment, and housing
Larger social issues (poverty, racism)

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2
Q

What is mental health

A

Finding a balance in all aspects of life
capacity to think, feel and express emotions and behave in ways that enhance personal capacity to manage life
sense of emotional and spiritual wellbeing

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3
Q

What is a mental disorder

A

constellations of co-occuring symptoms involvin alterations from absence of illness to maximal illness

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4
Q

Why is assessing mental health important

A

Early intervention
stigma
delay of treatment
housing difficulties
early treatment discontinuation
negative economic effect
addiction

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5
Q

Rwduce mental health stigma as providers

A

self reflect
self moniter
address own beliefs
address ow behaviours

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6
Q

Relational practices for mental health

A

respect
no judgment
reflection

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7
Q

Mental Health Nursing assesment

A

observation-manic phase?
interview
examination
physical assessment
collaboration with others

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8
Q

Mental status examination

A

emotional and cognitive functioning
domains include appearance, behaviour (mood and affect and speech, cognition (concentration, comprehension and abstract reasoning) and thinking (perception, content, process, insight, judgement)

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9
Q

Appearance for mental disorders

A

How do they look
grooming
facial expression
tremors
position
altertness
affect

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10
Q

What are their behaviours?

A

physical-pacing, crying, agitated, eye contact, withdrawn
Speech-loud, pressured, incoherant, slurred
self-care-excessive, appetite?

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11
Q

Cognition

A

orientation (time, place, person)
State of consciousness-lathergic, drowsy, alert
Mood-depressed, euphoric, labile
Memory-impaired (past/present)
Concentration (poor, good)
Judgement (impaired, good)
insight (none, limited, good)

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12
Q

thoughts

A

content-suicidal, homicidal, guilt, worthlessness, obsessions, phobias, paranoias, hallucinations, delusions

Process-coherent, logical, fleeting, tangential, attention(distracted or focused)

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13
Q

Indication for comprehensive Nursing Assessment

A

behaviour changes
brain lesions
aphasia
symptoms of psychiatric mental illness

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14
Q

Developmental considerations for mental health in adolescents

A

suicide
mental health disorders started around age 14
common disorders include depression, anxiety, ADHD, substance use
Eating disorders are also so common among Canadian Female teens

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15
Q

Mental Health assessment in adults

A

identification/biographical information
Reasons for seeking care
past health
family health hisotry
current health

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16
Q

Objective data-appearance

A

posture
body movements
dress
grooming and hygeine

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17
Q

objective data-bahviour

A

level of consciousness
facial expression
mood
affect

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18
Q

Objective data-cognitive functions

A

orientation
attention span
immediate memory
recent memory
remote memory
four unrelated word tests )additional testing for patientd with aphasia)

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19
Q

Objective data-higher intellectual functions

A

insight and judgement
thought process
thought content
perceptions

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20
Q

Supplemental Mental Status Examination

A

quick to administer
sensitivity for 90% for detecting mild cognitive impairement
good for dementia detection and delirium and difrentiationg these from psychiatric mental illness
MOCA is like the animals and shapes and fun little square drawings

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21
Q

Risk assessment

A

Suicidal thoughts
assaultive or homicdal ideation
elopement risk

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22
Q

Developmental considerations in children for mental health

A

knowledge of developmental milestones
Nipissing Developmental screen
other reliable screening tools

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23
Q

Developmental considerations for older adults and adults

A

Greater risk of alziehmers

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24
Q

CNO guideliness

A

Establishing therapeutic relations
-therapeutic communication
-client centered care
maintaining boundaries
-protecting client from abuse

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25
Q

Neurologic assessment developmental considerations for infants

A

neurons are not yet myeinated

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26
Q

neurologic assessment developmental considerations for older adults

A

general atrophy and loss of neurons in brain and spinal cord
decrease in weight and volume of brain
decreased muscle strength ad impaired fine coordination
slowed reaction time
dizziness and loss of balance

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27
Q

Cultural and social considerations for neurologic examinations

A

Greater risk for heart disease and stroke
intersecting factors of socio-economic factors, health care and preventative services and exercise
social circumstances and ability to manage post-stroke condition
importance of social resources

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28
Q

Subjective data for neurologic risks

A

headache
head injury
diziness or vertigo
seizures
tremors
weakess
incoordination
numbness or tingling
difficulty swallowing
difficulty speaking
significant past hisotry
envionmental hazards
medications

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29
Q

Additional neurologic examination health history questions for infants

A

maternal health
neonatal period
reflexes
weakness and balance
seizures
physical development
enviornmental hzards
ognitive development
family history

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30
Q

Additional health history questions

A

older adults
risk for falls
tremors
vision

31
Q

Critical findings in neurological exams

A

sudden changes in alterness
sudden changes in speech or onset of new difficulties
signs of a stroke
signs of increased intracranial pressure (headaches and vommiting)
sudden onset weakness, numbness, double vision
seizures
lathargy that persists or worsens

32
Q

Stroke

A

Face-drooping?
Arms-can you raise both
Speech-is it slurred or jumbled
Time-call 911

33
Q

Stroke prevention

A

early recognition of symptoms
vision changes
trouble walking, dizziness, loss of balance or coordination
sudden weakness
sudden severe headaches
(less common is vommiting, fainting)

34
Q

Modifiable risk factors of strokes

A

Cardiovascular disease
hypertension
smoking/second hand exposure
diabetes
atrial fibrillation
other cardiac conditions
dyslipidemia
asymptomatic carotid stenosis
sickle cell disease
postmenopausal hormone therapy
diet and nutrition
inactivity
obesity
ischemic attack history

35
Q

immodifiable risk factors for strokes

A

age
gender
low birth weight
ethnocultural background
genetic factors

36
Q

Prevention of strokes

A

diet
limit sodium intake
moderate excercis
maintain healthy weight
smoking cessation
limit alcohol intake
manage underlying health issues

37
Q

Physical Exam for Neuro

A

Prep-screen neuro
complete neuro exam
neuro recheck exam

equipment needed-penlight, tongue blade, cotton swab, cotton ball, tuning fork, percussion hammer, aromatic substances

38
Q

Cranial Nerves

A

I-Olfactory
II-Optic
III-oculomotor
IV-Trochlear
VI-Abducens
V-Trigeminal
VII-Facial
VIII-Acoustic
IX-glossopharyngeal
XI-spinal accessory
XII-hypoglossal

39
Q

OH OH OH To Taste and Feel Very good velvet ah heavenly

A

Olfactory
optic
oculomotor
trochlear
trigeminal
abducens
facial
vestibulocochlear
glossopharyngeal
vagus
accessory
hypoglossal

40
Q

Some say money matters but my brother says big brains matter more

A

correlates to order of cranial nerves

41
Q

Olfactory

A

sensory-sense of smell

42
Q

Optic nerve

A

sensory-visual acuity, visual fields, opthaloscope
Snellen chart

43
Q

oculomotor

A

pupillary, light response (motor)
PERRLA
eyelid droop

44
Q

Trochlear

A

Motor
cardinal gazes

45
Q

Trigeminal

A

sensory and motor
light touch to forehead (feel it)
try to open mouth while clenching and palpate

46
Q

Abduecens

A

motor

47
Q

facial

A

sour taste on tongue
smile, frown

48
Q

acoustic

A

sensory
whispered voice test, Weber and Rinne

49
Q

Glossopharyngeal

A

Motor and sensory
say ahhhh (gag reflex)

50
Q

Vagus

A

motor and sensory

51
Q

Spinal accessory

A

motor
rotate head and shoulders against movement

52
Q

Hypoglossal

A

motor
say light, tight, dynamite

53
Q

Anosmia

A

decrase or loss of smell
from tobacco smoking, allergic rhinitis, cocaine use
normal is aging decreases smell

54
Q

When to worry with cardinal gazes

A

unilateral dilation
non-reactivity
deviation in gaze
nystagmus

55
Q

nystagmus

A

eye makes repetitive uncontrolled movements

56
Q

When to worry with facial nerve

A

muscle weakness
flattening of nasolabial fold
lower eyelid sagging
escape of air from only one cheeck

57
Q

How to test acoustic cranial nerve? Vestibulocochlear

A

whisper test
weber test
rinne test

58
Q

Cranial Nerve

A

motor function of the tongue

59
Q

Objective Exam-Motor System

A

inspect and palpate muscles (size, strength, tone, involuntary movements)
cerebellar function (balance test-gait, tandem walking, romberg test(feet together and eyes closed)
Coordination and skilled movement (heel to shin test, rapid alternating movements)

60
Q

Physical Exam-sensory system

A

person is alert, cooperative and comfy
spinothalamic tract-pain, temp, light touch
posterior column tract-vibration, position, tactile discrimination (fine touch)

61
Q

Posterior column tract physical exam

A

vibration
position(kinesthesia)
Tactile discrimination (fine touch)
sterognosis-what object in hand
graphesthesia (write on hand)
two point discrimination
extinction
point location

62
Q

Neuro exam objective-sensory system rundown

A

pain-sharp vs dull
light touch-cotton whisp
vibration-tuning fork
position sense
graphesthesia-number tracing on hand
stereognosis-object recognition
2 point discrimination
extinction-both sides at same time
point location-point to location of touch

63
Q

objective Data-Physical Exam

A

test the deep tendon reflexes
-technique, grading, reinforcement, biceps reflex, triceps reflex, brachioradialis reflex, quad-patellar jerk), achilles, clonus (quivering reflex)

64
Q

What are the superficial reflexes

A

abdominal reflex
cremastic reflex
plantar reflex

65
Q

List 4 reflexes (common

A

bicep
tricep
quadricep
achilles

66
Q

Scale for reflexes

A

0=absent
1=hypoactive
2=normal
3=hyperactive
4=hyperactive with clonus
5=sustained clonus

67
Q

Developmental considerations for infants and neuro exam

A

spontaneuous walking activity, response to enviornment, social smile
cranial nerves-cant be directly tested
motor system-Nipissing District Developmental Screen
Head control
reflexes-plantar grasp, rooting, landau, babinski, moro, tonic neck

68
Q

Developmental considerations for reflexes in preschool and school age children

A

observation of dress/undress/buttons
milestones NDDS
test balance, fine motor coordination
sensation not reliable for testing

69
Q

Older adult neurologcal developmental considerations for objective exam

A

decrease in muscle bulk
snile tremors
dyskineasis (difficulty with smooth movements)
Difference in gait
loss of ankle jerk
deep tendon relfexes less brisk

70
Q

Neurological recheck

A

lovel of consciousness (time, place, person)
motor function
pupillary response
vital signs
glasgow coma scale

71
Q

Intracranial pressure signs

A

behavioural changes
decreased level of consciousness
headache (BAD)
lethargy
seizures
vommitting

72
Q

Glasglow Coma Scale

A

eye opening
4=spontaneuous
3=to sound
2=to prssure
1=no response
verbal response
5=oriented
4=confused
3=words
2=sounds
1=none
motor response
6=obeys
5=localizing
4=withdrawal
3=abnormal flexions
2=extension
1=none

73
Q

GlawGlow coma scaling scoring

A

Mild is 13-15
Moderate is 9-12
Severe is 3-8

Nursing 202 (15 decks)

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