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36 Cards in this Set
- Front
- Back
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Metal Status |
Cognitive and emotional functioning |
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Mental Health |
How well one functions in social, personal, work situations Dynamic: good days/bad days |
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Stressors |
May cause emotional-cognitive trauma and transient dysfunction Responses to traumatic events (grief reaction) are normal but may become pathologic if pt is unable to cope effectively Homelessness, unemployment, death of a loved one |
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Perform mental status exam |
When you observe altered mental status When family members notice change in mental status: may be the first to notice subtle changes When cerebral trauma has occurred |
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Mental Status exam |
General appearance Attitude and behavior Orientation: person, place, time Level of consciousness Mood Affect Speech Thought processes Cognition/intellect |
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General Appearance |
Neatly dressed/groomed Disheveled/dirty Other: tremors, twitching, excessive movement |
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Attitude and behavior |
Cooperative/polite Uncooperative Psychomotor agitation Psychomotor retardation Anxious Good eye contact Guarded/withholding Bizarre |
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Psychomotor agitation |
Agitated verbage or movement |
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Psychomotor retardation |
Delayed, slow responses |
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Level of consciousness |
Being aware of self/environment |
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LOC: Alert |
Awake or readily aroused |
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LOC: Lethargic |
Somnolent Drifts off to sleep Aroused by name Responds appropriately but slow |
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LOC: obtunded |
Sleeps continuously, difficult to arouse Arouse by shouting or vigorous shaking Requires constant stimulation Converses in monosyllables and mumbles |
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LOC: Stupor |
Unconscious Responds only to vigorous shaking or pain Withdraws from pain Cannot converse, may groan or mumble |
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LOC: coma |
unconscious and unresponsive to pain Light coma: may have reflexes Deep coma: no motor responses |
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Mood |
Subjective, how a person feels |
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Euthymic |
Normal mood |
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Euphoric |
Euphoric mood: exaggerated feeling of wellbeing, mild elation |
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Dysthymic |
Dysthymic mood: chronically depressed mood, >50% of the time for > 2 yrs |
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Dysphoric |
Feelings of depression and unrest without just cause |
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Affect |
Objective, observable emotions Appropriate Inappropriate Flat: absent emotional response Angry/irritable |
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Speech |
Normal rate and rhythm |
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Pressured speech |
Not necessarily fast Unable to break in or interrupt pt Seen in mania with bipolar disorder |
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Slow speech |
Seen with depression |
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Loud speech |
Unusually loud talking |
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Soft speech |
Unusually quiet talking |
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Thought processes |
Coherent Flight of ideas Delusions: false belief that appears real Paranoia: persecutory thinking associated with feelings of being treated wrongly Confusion |
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Cognition/Intellect |
Intact Fair Poor Grossly impaired Short and long term memory Field of knowledge: president, world events Insight: self-awareness of mental illness Judgement: ability to use facts to make correct decisions |
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Mood disorders |
Problems with mood or affect |
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Psychotic disorders |
Problems with thought processes |
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Dementia |
Problems with cognition |
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Mini mental status exam/MMSE |
Measures severity of cognitive impairment |
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Sundowners |
Often occurs with dementia Acute confusional state Worse at night, particularly when in an unfamiliar environment |
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Two question depression screen |
Great face validity and reliability Over the past 2 weeks, have you felt: - Down/hopeless - Little interest in doing things "Yes" to either question indicates positive screen for depression |
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Screen for suicidal thoughts |
With any expression of sadness, hopelessness, powerlessness Ask direct questions: - Have you ever been so sad you wanted to hurt yourself? - Are you thinking about hurting yourself now? - Do you have a plan? Do you have a gun? Seek help immediately if suicidal or homicidal ideation present |
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Aging adults |
Mental status remains intact, but no loss of general knowledge or vocabulary Slower response Recent memory may be impaired: difficult 2 hr recall Age related sensory perception can affect mental status: change in hearing, vision |
