NSG 200 Module 23 Cognition - Flashcards

Flashcards covering key vocabulary related to cognition assessment, neurological examinations, cranial nerves, motor/sensory function, levels of arousal, and stroke assessment (including GCS, BEFAST, and NIHSS).

Cognitive Assessment

Performed for initial screening of cognitive problems and monitoring changes over time.

Nursing Assessment (Observation)

Involves observing patient's appearance, dress, social skills, motor function, activity level, attention, focus, and ability to provide logical responses.

Nursing Assessment (Patient Interview)

Gathering information from the patient, family, or caregiver about biophysical/psychosocial history, development, family history, and environmental factors.

Medical History (Cognition)

Includes information on presenting problems, altered health patterns, patient development, illness, injury, health behaviors (e.g., substance use), and developmental milestones in children.

Physical Examination (Cognition)

Includes vital signs, pain level, auscultation of heart/lungs, neurologic signs, sensory evaluation (hearing, vision, touch, taste, smell), physical development, and motor function.

Mental Status Examination (MSE)

Assesses orientation, perception, thought content, attention, concentration, memory, speech/language/communication, mood, affect, and psychomotor activity.

Recent Memory

Assessed by asking about events from the immediate past, such as what the patient had for breakfast.

Remote Memory

Assessed by asking about historical personal facts (e.g., date of marriage, children's birthdays) or major historical events.

Alert (Conscious)

A level of arousal characterized by wakefulness and awareness of self and environment.

Lethargy

A mild reduction in alertness.

Obtundation

A moderate reduction in alertness with increased response time to stimuli.

Stupor

A state of deep sleep where the patient can be aroused only by vigorous and repetitive stimulation, returning to deep sleep when not continually stimulated.

Coma (Unconscious)

A sleep-like appearance, behaviorally unresponsive to all external stimuli (unarousable, eyes closed).

Cranial Nerve I (Olfactory)

Responsible for the sense of smell; tested by explaining and assessing the sense of smell.

Cranial Nerve II (Optic)

Responsible for vision; tested using a Snellen chart for each eye.

Cranial Nerves III, IV, VI (Oculomotor, Trochlear, Abducens)

Responsible for extraocular movements (EOMs) and pupillary responses; tested together using 6 cardinal fields of gaze and direct/consensual pupillary response.

Cranial Nerve V (Trigeminal)

Responsible for facial sensation and mastication; tested for facial sensation, jaw clenching, and corneal reflex.

Cranial Nerve VII (Facial)

Responsible for facial muscle movement and taste to the anterior 2/3 of the tongue; tested by smiling, frowning, puffing cheeks, closing eyes tightly, and assessing taste.

Cranial Nerve VIII (Acoustic/Vestibulocochlear)

Responsible for hearing and balance; tested using whisper/ticking clock, Weber, and Rinne tests.

Cranial Nerves IX, X (Glossopharyngeal, Vagus)

Responsible for swallowing, gag reflex, and taste to the posterior 1/3 of the tongue; tested by assessing swallow, phonation (hoarseness), and tongue movement.

Cranial Nerve XI (Spinal Accessory)

Responsible for shoulder shrug and head turning against resistance; tested by assessing trapezius and sternocleidomastoid muscles.

Cranial Nerve XII (Hypoglossal)

Responsible for tongue movement; tested by asking the patient to stick out and move the tongue side-to-side.

Supination / Pronation Test

A gross motor test assessing the ability to move hands equally without lagging.

Finger to Nose Test

A gross motor test assessing coordination and presence of ataxia.

Heel Down Opposite Shin Test

A gross motor test assessing coordination and presence of ataxia.

Romberg Test

A gross motor test assessing steadiness by having the patient stand with feet together, looking for swaying.

Gait Tests

Assess walking patterns, including walking across a room, heel-to-toe, on toes, and on heels.

Ataxia

Impaired coordination, often identified during cerebellar function testing.

Pain (Sharp / Dull) Sensory Test

A fine motor/sensory test differentiating sharp vs. dull sensations on the face, arms, and legs.

Light Touch Sensory Test

A fine motor/sensory test assessing the ability to detect light touch, both singly and bilaterally.

Kinesthesia

The sense of position awareness; tested by identifying finger positions with eyes closed.

Stereognosis

The ability to identify common small items placed in the hand with eyes closed.

Graphesthesia

The ability to identify numbers traced in the palm of the hand with eyes closed.

Babinski Reflex

Tested by tracing the bottom of the foot; normal in babies, abnormal in adults if toes curl or spread.

Glasgow Coma Scale (GCS)

A neurological scale used to assess the level of consciousness based on eye opening, verbal response, and motor response.

Minor Brain Injury (GCS)

Indicated by a GCS score of 13-15 points.

Moderate Brain Injury (GCS)

Indicated by a GCS score of 9-12 points.

Severe Brain Injury (GCS)

Indicated by a GCS score of 3-8 points.

Stroke Symptoms

May include facial drooping, arm/leg weakness, speech difficulties, vision loss, dizziness, confusion, incontinence, tingling, or numbness.

Last Known Normal

A crucial data point in stroke assessment, referring to the last time the patient was observed without symptoms.

Onset of Symptoms

A crucial data point in stroke assessment, referring to the precise time when stroke symptoms first began.

BEFAST

An acronym used to quickly recognize stroke symptoms: Balance, Eyes, Face, Arms, Speech, and Time to call emergency services.

NIHSS (National Institutes of Health Stroke Scale)

A standardized scoring tool used to assess neurological deficits and severity of a stroke, with higher scores indicating greater severity.

Expressive Aphasia

Difficulty speaking or formulating language, often observed after a stroke or brain injury.