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person's emotional (feelings) and cognitive (knowing) function |
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-person's response is much greater than the expected reaction to a traumatic life event -significant behavioral or psychological pattern associated with distress (painful symptom) or distress (impaired functioning) |
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due to brain disease of known specific organic cause (e.g. delirium, dementia, alcohol & drug intoxication & withdrawal) |
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psychiatric mental illness |
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organic etiology not yet established (e.g. anxiety disorder or schizophrenia) |
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appearance, behavior, cognition, though processes |
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-older adulthood contains more potential for losses -grief & despair surrounding these losses can result in disability, disorientation, or depression -chronic diseases such as heart failure, cancer, diabetes, & osteoporosis include fear of loss of life |
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check sensory status, vision, & hearing before any aspect of mental status |
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-screens for cognitive impairment in otherwise healthy adults -consists of a 3-item recall test & a clock-drawing test |
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awake or readily aroused, oriented, fully aware of external & internal stimuli & responds appropriately, conducts meaningful interpersonal interactions |
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LOC: Lethargic (or Somnolent) |
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not fully alert, drifts off 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 |
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sleeps most of the 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 |
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spontaneously unconscious, responds only to persistent and vigorous shake or pain; has appropriate motor response (i.e. withdraws hand to avoid pain); otherwise can only groan, mumble, or move restlessly; reflex activity persists |
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clouding of consciousness (dulled cognition, impaired alertness); inattentive; incoherent conversation; impaired recent memory; disoriented |
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disorder of voice-difficulty or discomfort in talking, with abnormal pitch or volume due to laryngeal disease. Voice sounds hoarse or whispered, but articulation & language are intact |
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articulation-distorted speech sounds; speech may sound unintelligible; basic language (word choice, grammar, comprehension) intact |
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language comprehension & production secondary to brain damage--true language disturbance, defect in word choice & grammar or defect in comprehension; defect is in higher integrative language processing |
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lack of emotional response; no expression of feelings; voice monotonous & face immobile |
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depersonalization (lack of ego boundaries) |
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loss of identity, feels estranged, perplexed about own identity & meaning of existence |
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joy & optimism, overconfidence, increased motor activity |
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excessive well-being, unusually cheerful or elated, which is inappropriate considering physical & mental condition |
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worried, uneasy, apprehensive from the anticipation of a danger whose source is unknown |
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worried, uneasy, apprehensive; external danger is known & identified |
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Four Unrelated Words Test |
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tests the person's ability to lay down new memories-highly sensitive & valid-requires more effort than does the recall of personal & historical events-tell patient 4 unrelated words & ask them to repeat them back to you in 5, 10, & 30 mins. |
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Risks for Homicide/Suicide |
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screen for sadness, hopelessness, despair, or grief. Have you ever felt so blue you thought of hurting yourself? Do you feel like hurting yourself now? Do you have a plan to hurt yourself? How would you do it? What would happen if you were dead? How would other people react if you were dead? |
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assessing cognitive function |
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Orientation- Attention Span Recent Memory Remote Memory New Learning |
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