SK Final

Suicide: Depression Screening

PHQ9

Alcohol: For withdrawal

CIWAA

Alcohol use disorder

Audit

The older the client and the decline in cognition, what principles should you use to assess their mental status?

Age related changes, and dementia

Give me one example of how would you assess the judgment cognitive function?

What would you do if you were in pain?

What is a problem that can be affected with your temporal lobe if a lesion is present?

Balance possibly aphasia

What is Aphasia?

Language impairment/language barrier

Language that lacks meaning is Wernicke’s aphasia.

This is when you have a posterior temporal lobe lesion.

One tool that helps you identify signs of dementia?

SLUMS test

What other tools are used to assess signs of dementia?

Hazardous affects of alcohol

Person is unconscious, eyes are closed, what would you be documenting their status as?

Coma

Why do you have to do a mental health assessment early on in your assessment?

To validate what the patient is saying.

How do you assess remote memory?

Where were you born? or What was your first job?

What is decorticate and decerebrate positioning?

Decerebrate: hands extended, pronated arms, plantarflexion feet (seen in meningitis)

Decorticate: arms flexed; legs extended

If I ask a person to draw the face of a clock, what am I assessing?

Virtual perception

Give me an example of abstract reasoning?

-Two birds with one stone

-People in glass houses shouldn’t throw stones

Which aspect would you identify that would help you identify the cognitive ability of a person?

Orientation x4: Person, Place, Time, Situation

Stooping over, slow shuffles… What gait is this?

Parkinson’s gait

What do you do with the Romberg’s test?

Testing the cerebellum

When testing the cerebellum what neurological assessment are you focusing on?

balance and coordination

What are some modifiable risk factor for stroke?

Smoking, Drinking, Diet 

What does CN 1 involve?

Smell

What does CN 9 and 10 involve?

Gag reflex and Uvula

What are you assessing when you’re assessing the trigeminal nerve?

-Clinching of the teeth and that their face muscles are working

-For motor, clinch their teeth and see that their face muscles are working properly

-For sensory, you make sure they can identify sharp or dull pain

-For Corneal reflex, you would put a cotton ball on cornea making sure patient can blink.

 

If you’re unable to assess the patella, what would you do?

You would inner lock the fingers and pull.

How do you grade your reflexes?

0-4

Which number would you rate a brisk reflex?

3

If a person has a cranial nerve III (oculomotor) damage, what is going to happen?

Pupils will be unresponsive to light, and they will not be able to dilate.

What is DTR

Deep tendon reflex

Tell me where you would elicit your triceps reflex?

Above the olecranon process

Where are you tapping to elicit the triceps reflex?

Over the tendon of the olecranon process

How are you going to hold your reflex hammer?

You will hold between your thumb and index finger lightly

Person has unsteady gait, with feet together, what gait do they have? What problem?

Cerebellar ataxia and they would have problems with their coordination and balance

hat is graphapisia?

When you draw a number on the inside of their palm, if they get it wrong that is a positive test

One assessment for balance which we should omit for older clients is…?

Hopping during Romberg test.

If they have an injury to the cerebellum, what signs can you anticipate?

Balance and coordination problems

What is a bulge test?

Seeing for fluid in the tissue of the patella

What would be the inference if your hands are tingling when you’re doing the Phalen’stest?

Carpal tunnel syndrome

What is the first assessment you would do of the musculoskeletal system?

Assess their gait

What is a range of motion test for the elbows?

Flexion, extension, supination, and pronation

What should you do if you find someone with Parkinson’s Gait?

Further assess them.

What is Parkinson’s gait?

A gait pattern marked by increased forward flexion of the trunk and knees; gait is shuffling with quick and small steps; festinating may occur.

What is the term you would give for a swollen metatarsal phalangeal?

Gout Arthritis

Fever, chills, neck pain/stiffness (Nuchal rigidity), and headache… What are these symptoms of?

Meningitis

What kind of deficiencies lead to osteoporosis?

Vitamin D (vitamin C too Aspen)

What would be a positive response a Phalen’s test?

Tingling/numbness in the fingers

Spinal accessories, what are you going to assess?

Shrugging the shoulders

What is a problem if your patient complains of TMJ pain?

Chewing

How would you elicit tenderness of the kidneys?

Blunt percussion

What prominent sound you would hear over the abdomen when you percuss?

Tympanic

When auscultating, when would you say there are no bowels sounds?

If there are no sounds after 5 minutes in all four quadrants

What are some things you need to do before performing an abdominal assessment?

Empty the bladder, Auscultate before you palpate, Have them wear a gown so they can remove their clothing, and bend their knees and put a pillow under to relax their muscle

What is Cullen’s sign?

Internal-abdominal bleeding around the umbilicus.

If you observe a peristaltic wave at the abdomen, what would you do?

LAPE test, then you need to further follow up and find out what the problem is

Different shapes of the stomach are…

Scaphoid, Flat, Protrude, and Round

What is Murphy’s sign?

Direct downward pressure at a 90-degree angle with a single hand. Report of pain on palpation is the result of the tissues pressing into an inflamed gallbladder

which organs are solid

spleen, liver, kidney/adrenal glands, and pancreas

What are the 7 f’s

Fat, fluid, flatus, feces, fetus, fatal growth, and fibrous

Where would you palpate for the bladder? (distended urinary bladder)

hypogastric region above the pubic symphysis

If a patient is having involuntary reflex coughing upon inspiration, what would that mean?

pain and infection