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Neuro & Mental Statu

p. 552 werber assessment techniques

QuestionAnswer
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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