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Neuro & Mental Statu
p. 552 werber assessment techniques
| Question | Answer |
|---|---|
| Client Prep 4 nero exam ? | gown, sit on table, explain position changes, long exam provide rest as needed,actions may seem unusual |
| equiptment and supplies? | general=gloves, mental status exam= mini mental state examination pencil paper, Cranial Nerve exam =q tip, newsprint, ophthalmoscope,paper clip, pen light, snellen chart, cotton ball, substance 2 smell & taste,tongue depressor, tuning fork, |
| equiptment and supplies? 4 exams ?motor & cellebe | motor & cellebe= tape measure,Sensory = cotton ball objects to feel ie key, tuning fork & reflex hammer |
| Mental status 1. access level of consciousness | 1. call clients name note response(if no response) 2. call louder shake, (If no response)call louder apply a painful stimulus sternum rub |
| Mental status 1. Normal finding access level of consciousness | client alert awake, |
| Mental status 1. Name 4 abnormal levels of consciousness | Lethargy,2 obtunded, 3, stupor, 4. coma |
| Lethargy, | opens eyes answers questions falls back asleep |
| obtunded | opens eyes 2 loud voice, slow respond, confusion sems unaware of enviroment |
| ophthalmoscope, | An instrument for examining the interior structures of the eye, especially the retina, consisting essentially of a mirror that reflects light into the eye and a central hole through which the eye is examined. |
| stupor, 4. | awakes 2 vigrious shake or painful stimuli, returns 2 unresponsiveness |
| to all stimuliseyes closedcoma | unresponsive |
| decorticate posture | extends arms & legs,arches neck rotates hands & arms internally |
| what causes a decorticate posture | clients with lesions of the diencephalon,midbrain or pons |
| diencephalon | The posterior part of the forebrain that connects the midbrain with the cerebral hemispheres, encloses the third ventricle, and contains the thalamus and hypothalamus. Also called betweenbrain, interbrain; Also called thalamencephalon. |
| Decerebrate | abnormal extensor posture when stimulated |
| decebrate | arms=adducted, elboes extended, forearms internally rotated palms pronated (away from midline) feet = plantar flexed |
| In a mental status exam how is appearance and behavior noted ? | Posture & body movement (552 4 details )2= dress grooming hygine, (553) 2.2= facial expressions =meye contact & affect 4= speech tone clarity & pace |
| affect | Feeling or emotion, especially as manifested by facial expression or body language: “The soldiers seen on television had been carefully chosen for blandness of affect” (Norman Mailer). |
| How is mood feelings and expressions noted? | ask client How ru feeling today? What r your plans 4 the future? |
| How are thought processes and perceptions observed? | observe 4 clarity, content, and perceptions, inquire about clients thoughts and perceptions expressed ie Tell me more about what u just said. tel me what your understanding is of the current situcation or your heaklth. |
| when assessing mental status of older client be sure to first check what what and why? | vision & hearing b-4 assuming the client has a mental problem. |
| What are cognative abalities observed? | Orientation, recent memory, remote memory, use of memory to learn new information, abstract reasoning |
| How is the cognative abality of orientation observed? | ask person, time and place |
| How is the cognative recent memory observed? | ask client what they had to eat today or what the wheather is like |
| How is the cognative remote memory observed? | ask when did u get your 1st. job. When is birthday? |
| How is clients use of memory to learn new information observed? | repeat 4 unrelated words ie rose hammer, car, brown have client repeat words in 5, 10 & 30 min period |
| How is abstract reasoning observed? | client compares objects ie=how are an apple and an orange the same? how r they different? a proverb ie a stitch in time saves nine. if client has limited education note their abality to joke or use puns |
| How is judgement observed? | ask client what would u do if u were driving and a police car was behind you with lights & sirin turned on? |
| How is the constructional abality observed?constructional =Pertaining to, or deduced from, construction or interpretation.Ability =The quality of being able to do something, especially the physical, mental, financial, or legal power to accomplish somethin | ask client to draw face of a clock or copy simple figures |
| CN I tested ? | (blank) |
| CN II tested? | snellen, read, confrontation & opthalmascope |
| III, IV, & VI tested ? | 1. inspect margins of eyelids of each eye2. access extraocular movements, assess pupillary responses to light direct, indirect and accommodation |
| what is noted while . inspecting margins of eyelids of each eye | eyelid covers 2 mm of iris |
| . access extraocular movements, | corneal light reflex test, cover test,positions test |
| corneal light reflex test | assesses parallel alignment of eyes. !. hold penlight 12 inches away shine = bridge of nose client = stare stright ahead. Note light reflected on corneas normal light = exact same spot each eye |
| cover test, | detects deviation in alignment = interupts (fusion reflex) AKA = normally keeps eyes parallel. client stare ahead focus on a distant object cover 1 eye, while doing note any movement in uncovered eye. Uncover covered eyewhile doing observe 4 movement |
| positions test = | acess muscle strength & cN function, client = focus on object I am holding 12 in ches from face, move through 6 cardinal positions of gaze clockwise observe clients eyemovement |
Created by:
garrowcousino
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