Mental Status And Pain Assessment Vocab

Front 1

Consciousness

Back 1

Being aware of one's own existence, feelings, and thoughts and aware of the environment. This is the most elementary of mental status functions

Front 2

Mood

Back 2

Deal with the prevailing feelings. More durable, prolonged display of feelings that color the whole emotional life

Front 3

Affect

Back 3

Deal with the prevailing feelings. Temporary expression of feelings or state of mind

Front 4

Orientation

Back 4

The awareness of the objective world in relation to the self

Front 5

Lethargic

Back 5

AKA Somnolent, drowsy, not fully alert, driifts oft to sleep when not stimulated, can be aroused to name when called in normal voice but looks drowsy, responds appropriately to questions or commands but thinking seems slow and fuzzy, inattentive, loses train of thought, spontaneous movements are decreased

Front 6

Obtunded

Back 6

Confused (transitional stage between stupor and lethargy) Sleeps most of time, difficult to arouse - needs loud shout or vigorous shake, acts confused when is aroused, converses in monosyllables, speech may be mumbled and incoherent, requires constant stimulation for even marginal cooperation

Front 7

Delirium

Back 7

Acute confusional change (dulled cognition, impaired alertness, inattentive, incoherent conversations, impaired recent memory, and confabulatory for recent events) or loss of consciousness and perceptual disturbances (may be agitated and having visual hallucinations, disorientation, confusion that is worse at night), may accompany acute illness (pneumonia, alcohol/drug intox) and resolved when underlying cause is treated
25% of aging adults admitted into hospital with acute delirium, 56% develop acute delirium during hospitalization

Front 8

Dementia

Back 8

gradual, progressive process causing decreased cognitive function, even though the person is fully conscious and awake. Not reversible.
(Alzheimer disease accounts for 2/3 cases of dementia in older adults)
Affects 10% of adults older than 65, 50% older than 90

Front 9

Semi-Coma

Back 9

AKA stupor. Spontaneous unconscius, responds only to persistent and vigorous shake or pain; has appropriate motor responses (withdraws hands to avoid pain); otherwise only groans, mumbles, or moves restlessly. Reflex activity persists

Front 10

Coma

Back 10

Complete unconsciousness, no response to pain or any external or internal stimuli (when suctioned, does not try to push the catheter away); light coma has some reflex activity but no purposeful movement, deep coma has no motor response

Front 11

Euphoria

Back 11

Excessive well-being, unusually cheerful or elated, which is inappropriate considering physical and mental condition, implies a pathologic mood
Ex: "I feel on top of the world"

Front 12

Lability

Back 12

Rapid shift of emotions. Person expresses euphoric, tearful, angry feelings in rapid succession

Front 13

Illusion

Back 13

Misperception of an actual existing stimulus, by any sense
Ex: sees things that are not there

Front 14

Transduction

Back 14

First phase of nociceptive pain. Occurs when a stimulus (traumatic or chemical injury) takes place in the periphery (skin, somatic and visceral structures.). Travel to the dorsal horn at the spinal cord.
Ex: burn, incision, tumor

Front 15

Transmission

Back 15

Second phase of nociceptive pain. The pain impulse moves from the spinal cord to the brain. If not blocked by opiods at the synaptic clef, message continues to thalamus and then to the higher cortical areas.

Front 16

Perception

Back 16

Third phase of nociceptive pain. Brains conscious awareness of painful sensation. Part of the limbic system emotionalizes a response to the stimuli and is then identified as pain.

Front 17

Visceral Pain

Back 17

Pain from larger interior organs (kidneys, intestines, stomach, gallbladder, pancreas) caused by trauma, stretching, contraction. Pain usually presented with vomiting, nausea, pallor, diaphoresis. Often referred.
Ex: utereral colic, acute appendicitis, ulcer pain, cholecystitis

Front 18

Deep Somatic Pain

Back 18

Pain from blood vessels, joints, tendons, muscles and bone. Caused by pressure, trauma, ischemia
Ex: Sprain, broken bone

Front 19

Cutaneous Pain

Back 19

Pain derived from skin surface & SQ tissues. Injury is superficial w/ sharp, burning sensation.
Ex: paper cut

Front 20

Referred Pain

Back 20

Pain felt in a particular site, but originates from another location. Both sites are innervated by the same spinal nerve and is difficult for the brain to differentiate the point of origin. May be visceral or somatic. Due to embryonic innervation

Front 21

Chronic Pain

Back 21

AKA Persistent pain. >6mo. Does not stop when injury heals. Subdivided into
Malignant (cancer related) parallels pathology created by tumor, induced by stretching or necrosis & fluctuates with course of disease.
Nonmalignant caused by musculoskeletal conditions such as arthritis, low back pain, fibromyalgia

Front 22

Acute Pain

Back 22

Pain is <6mo., self-limiting and dissipates after injury heals.
Ex: surgery, trauma, kidney stones

Front 23

Breakthrough Pain

Back 23

Pain that starts again or escalates before the next scheduled analgesic dose.

Front 24

Reflexive Sympathetic Dystrophy

Back 24

Chronic progressive nerve condition characterized by burning pain, swelling, stiffness, and discoloration of the affected extremity. Affects adults 40-60yr, occurs weeks to months after nerve injury (Carpal tunnel, broken leg, cerebral lesions). Light brushing of a cotton ball can create a severe, intense painful response.
Swelling, disappearance of wrinkles, cool skin temperature, , discoloration, brittle nails, atrophic changes - pale, dry, shiny skin and muscle atrophy.
Treatment - medication and PT