Assessing Mental Status and Substance Abuse – Vocabulary Review

Vocabulary flashcards covering key terms and concepts from the lecture on assessing mental status, dementia, delirium, and substance abuse.

Mental Status

A client’s level of cognitive and emotional functioning as observed through behaviors; cannot be measured directly.

WHO Definition of Health

A state of complete physical, mental, and social well-being, not merely the absence of disease.

Factors Affecting Mental Health

Economic and social conditions, lifestyle choices, exposure to violence, personality, spiritual and cultural influences, neurologic changes, and developmental issues.

Dementia

A set of symptoms involving progressive loss of cognitive function such as memory, judgment, language, and problem solving.

Alzheimer’s Disease

The most common form of dementia, featuring gradual, irreversible decline in memory and other cognitive abilities.

Typical Age-Related Changes

Normal slowing of thinking, problem solving, and recall without major impairment or loss of independence.

Non-modifiable Alzheimer’s Risk Factors

Increasing age, genetic predisposition or family history, and Latino or African American ethnicity.

Modifiable Alzheimer’s Risk Factors

Hypertension, high cholesterol, head trauma, smoking, dysrhythmias, depression, and hormone replacement therapy (HRT).

Alzheimer’s Prevention Education

Engage in mentally challenging tasks, maintain healthy weight, eat heart-healthy diet, exercise, avoid tobacco/excess alcohol, stay socially connected, protect head, and discuss HRT.

Substance Use Disorder Goal

To reduce substance abuse and protect the health, safety, and quality of life of all people.

CAGE Questionnaire

Four alcohol-use screening questions: Cut down, Annoyed, Guilty, Eye-opener; ≥1 “yes” suggests a problem.

COLDSPA

Assessment mnemonic: Character, Onset, Location, Duration, Severity, Pattern, Associated factors.

Mental Status Exam (MSE)

Systematic assessment of appearance, behavior, cognition, and thought processes integrated into the health history.

Indications for Full MSE

Positive screens for anxiety, depression, cognitive impairment, memory loss, inappropriate interaction, brain lesions, or aphasia.

Level of Consciousness (LOC)

Degree of alertness ranging from alert and oriented to coma; assessed first in mental status evaluation.

Glasgow Coma Scale

Tool rating eye opening, verbal, and motor responses; scores 3–15, with ≤7 indicating coma.

Lethargy

Opens eyes, answers questions, then drifts back to sleep.

Obtunded

Arouses to loud voice, responds slowly with confusion, unaware of environment.

Stupor

Responds only to vigorous or painful stimuli then returns to unresponsive sleep.

Coma

Unresponsive to all stimuli; eyes remain closed continuously.

Decorticate Posture

Abnormal flexion of arms with clenched fists and extended legs, indicating midbrain damage.

Decerebrate Posture

Abnormal extension and pronation of arms with plantar-flexed legs, indicating brainstem injury.

Posture, Gait, Body Movements

Normal relaxed stance with erect shoulders and rhythmic, coordinated gait; deviations may signal depression, schizophrenia, or neurologic disease.

Affect

Observable expression of emotion; should be appropriate to situation.

Dysarthria

Difficulty forming words due to neurologic disorder.

Quick Inventory of Depressive Symptomatology

Self-report tool measuring sleep, appetite, mood, energy, psychomotor changes, and suicidal thoughts.

SAD PERSONS Scale

Mnemonic suicide-risk assessment: Sex, Age, Depression, Previous attempt, Ethanol abuse, Rational thinking loss, Social support lacking, Organized plan, No spouse, Sickness.

Orientation

Awareness of person, place, and time; time is lost first, person last.

Recent Memory

Recall of events within minutes or hours, e.g., today’s weather or arrival time.

Remote Memory

Recall of distant past events such as historical dates; loss suggests cortical dysfunction.

Four Unrelated Words Test

Assessment of new learning by recalling four unrelated words after 5, 10, and 30 minutes.

Abstract Reasoning

Ability to understand similarities, metaphors, or proverbs; deficits seen in schizophrenia and dementia.

Judgment (Cognitive Skill)

Capacity to make sound decisions in real-life scenarios; impaired in organic brain syndrome or schizophrenia.

Clock-Drawing Test

Simple drawing task assessing visual, perceptual, and constructional abilities; failure indicates parietal lobe dysfunction or dementia.

Confusion Assessment Method for the ICU (CAM-ICU)

Tool for detecting delirium based on acute change, inattention, altered consciousness, and disorganized thinking.

Seven Warning Signs of Alzheimer’s

Repetition of questions/stories, forgetting familiar tasks, financial errors, getting lost, neglected hygiene, misplaced objects, reliance on others for decisions.

Delirium

Acute, reversible disturbance in consciousness and cognition caused by illness, drugs, or metabolic imbalance.

Vascular Dementia

Chronic, progressive cognitive decline resulting from cerebrovascular disease, often abrupt after stroke or TIA.

Substance Self-Medication

Client use of alcohol or drugs to cope with pain, stress, or mental illness, important to assess during history.