NR 509-2 FINAL EXAM STUDY GUIDE -2022 JULY UPDATE REVISED VERSION

Chapter 5 Ashley (1-6)/ Catlin (7-9) Behavior/Mental Health Assessment and Modification for Age -Unexplained conditions lasting >6weeks should prompt screening for depression, anxiety, or both -PRIME-MD (Primary Care Evaluation of Mental Disorders). 26 questions and take 10 minutes to complete. Used for the 5 most common=anxiety, depression, alcohol, somatoform, and eating disorders. -Patient indications for Mental Health Screening: 1. Medically unexplained physical symptoms-more than half have depression and anxiety disorders 2. Multiple physical or somatic symptoms or high symptom count 3.High severity of the presenting somatic symptoms, chronic pain 4.Symptoms for more than 6 weeks 5. Physician rating as a “difficult encounter” 6. Recent stress 7. Low-self rating of overall health 8.Frequent use of health care services 9.Substance abuse. -CAGE=substance-related and addictive disorders Modification for Age Elderly: -Complain of memory problems but usually is due to benign forgetfulness -Retrieve and process data more slowly and take longer to learn new information -Slower motor responses and their ability to perform complex task may diminish -Important to distinguish age-related changes from manifestations of mental disorders -More susceptible to delirium which can be the first sign of infection, problems with medications, or impending dementia Infant: Assess mental status of a newborn=observing newborn activities 1.Look at human faces and turn to parents voice 2. Ability to shout out repetitive stimuli 3. Bond with caregiver 4.Self-soothe Normal VS. Abnormal Findings and Interpretation -Mood disorders: compulsions, obsessions, phobias, and anxieties -Lethargic: drowsy, but open their eyes and look at you, respond to questions, and then fall asleep. -Obtunded: open their eyes and look at you, but respond slowly and are somewhat confused. -Agitated depression: crying, pacing, and hand-wringing -Depression: the hopeless slumped posture and slowed movements. -Grooming and personal hygiene may deteriorate: Depression, schizophrenia, and dementia -Manic Episode: the agitated and expansive movement of a manic episode