NURS 612 EXAM 3 ( Mental assessment.)

1.What is the purpose of assessing person place and time? pg 67 Purpose is evaluate the cognitive function of a pt based on mental status components: orientation (determine level of confusion), memory, fund of knowledge, attention span, concentration, language, and abstract thoughts. o Person disorientation results from: cerebral trauma, seizures, or amnesia o Place disorientation results from: psychiatric disorders, delirium, and cognitive impairment. o Time disorientation results from: anxiety, delirium depression, and cognitive impairment 2. How many serial numbers should most be able to repeat? Pg 70 • Serial numbers repetition test a patients immediate recall or new learning (memory) o Ask the patient to listen then repeat a sentence or a series of numbers o Five to eight numbers forward or four to six numbers backward can usually be repeated 3. How do you assess recent memory? Pg 70 • Recent Memory: Give the pt a short time to view 4 or 5 test objects stating that you’re going to ask them about them again in a bit. 10 mins later, ask the pt to list the objects. All objects should be remembered • Remote memory: Ask the pt to verify their mother’s maiden name, the high school they attended, military branch, or a subject of common knowledge. *Memory loss can result from a disease, infection, temporal lobe trauma. Impaired memory with various psychiatric disorders such as anxiety and depression. Loss of immediate and recent memory with retention of remote memory suggests dementia. 4. What psych condition is considered progressive and not reversible? Pg 78 Dementia • A chronic, slowly progressive disorder of failing memory, cognitive impairment, behavioral abnormalities and personality changes that often begins after age 60 years • Usually related to structural disease in the brain • Consciousness not impaired except in severe cases • Minimal cognitive impairment initially, worsens as progresses • Mood and affect is depressed, apathetic, uninterested • Speech is disordered, rambling, incoherent, struggles to find words • 70% cases are Alzheimer’s dementia, 20% vascular (acute or recurrent embolic strokes, cerebral hemorrhage due to HTN,) 10% assoc. with Lewy bodies in brain, Parkinson ds., frontal lobe degeneration 5. If a pt is delirious, does he maintain orientation and attention span? Pg 767,6 • Delirium is usually sudden onset with an altered level of consciousness • Orientation usually abnormal, may fluctuate. o Place and time disorientations occur with delirium o Impaired short-term and long-term memory, altered consciousness • Attention span prominently abnormal, fluctuates. o Impaired concentration, reduced attention span, slower thought process, indecisiveness, illogical flow of ideas o Numerous errors in assessment tasks