NUR 2730 Mental Status and Neuro Assess Spr 25 - Tagged

Brain Anatomy and Functions

• Primary Sensory Cortex (Postcentral Gyrus)

• Processes sensory information from the body (touch, pain, temperature).

• Primary Motor Cortex (Precentral Gyrus)

• Responsible for the planning, control, and execution of voluntary movements.

• Somatic Motor Association Area (Premotor Cortex)

• Involved in the planning of complex movements.

• Somatic Sensory Association Area

• Integrates sensory information and provides context to sensory inputs.

• Visual Cortex

• Processes visual information from the eyes.

• Visual Association Area

• Integrates visual stimuli with prior knowledge and interpretations.

• Wernicke's Area

• Critical for language comprehension (understanding speech).

• Broca's Area

• Responsible for speech production and language processing.

• Auditory Cortex

• Processes auditory information (sounds).

• Auditory Association Area

• Involved in interpreting sound and understanding language patterns.

• Prefrontal Cortex

• Associated with decision-making, personality expression, and social behavior.

Mental Health Assessments

• Recognizing Mental Disorders

• Healthcare providers often miss subtle signs of mental illness.

• Importance of screening to detect mental health issues and potential harmful behaviors.

• Empathy and Observation

• Active listening and close observation are essential in identifying the patient's perspectives, concerns, and habits.

The Challenges in Nursing Assessment

• Patients often present with overlapping symptoms of mental health disorders and other medical conditions.

• Comprehensive assessment is crucial to ensure patient health and quality of life.

Understanding Symptoms

• Symptoms may be:

• Psychological: Related to mood or anxiety disorders.

• Physical: Manifesting as somatic symptoms (e.g., pain, fatigue, palpitations).

• Medically Unexplained Symptoms: Approximately 30% of symptoms have no clear medical cause.

• Functional Syndromes: Frequently co-occur with shared symptoms and distinct abnormalities.

Important Screening Tools

• Depression Screening:

• Use of PHQ-2 or PHQ-9 questionnaires.

• Suicide Screening:

• Utilize ASQ (Ask Suicide-Screening Questions).

• Alcohol Abuse:

• Use AUDIT (Alcohol Use Disorders Identification Test).

• Substance Abuse:

• Implement DAST-10 (Drug Abuse Screening Test).

• Dementia Screening:

• Employ MMSE (Mini Mental-State Exam).

Level of Consciousness and Orientation

• Orientation: Defined as awareness of personal identity, place, and time (A&O x 4).

• Levels of Consciousness:

• Ranges from normal alertness to coma.

• Classified as confused, delirious, somnolent (lethargic), obtunded, stuporous, or comatose.

Mood Assessment

• Different states of mood can include:

• Sadness, contentment, joy, anger, anxiety, and detachment.

Assessment of Appearance and Behavior

• Awake and Alert or Lethargic: Observing posture, motor function, and dress/hygiene.

• An unusual demeanor might indicate mental health issues (e.g., appropriate vs. extreme affect).

Speech and Language Assessment

• Parameters to consider include quantity, rate, loudness, articulation, and fluency of speech.

Neurological Assessment Methods

• Mini-Mental State Exam:

• Assess orientation, registration, attention, recall, and language.

• Total score indicates mental status from fully alert (15) to comatose (3).

Cranial Nerves Overview

• Cranial Nerves 1-12: Each with specific sensory and motor functions, such as olfactory (smell), optic (vision), oculomotor (eye movement), etc.

• Memory Aids: Use mnemonic devices for recalling CN functions.

Health History and Symptoms Assessment

• Gather specifics on chronic conditions, medication use, and any significant changes in movement or sensation.

• Specific Symptoms to Investigate: Headaches, dizziness, sensory changes, weakness, and others.

Neurological Conditions

• Common chronic neurological conditions include Multiple Sclerosis, Parkinson's disease, Alzheimer’s, ALS, and Huntington's disease.

Integrating Exams

• Incorporate mental status, speech, and hearing observations into the physical examination.

• Assess neurologic abnormalities during the evaluation of peripheral vascular and musculoskeletal systems.

Reflex Assessment

• Assess Deep Tendon Reflexes (DTRs): Compare normal and abnormal responses.

Health Promotion Strategies

• Recognizing signs of stroke and the importance of timely intervention: Use the acronym BE FAST for memory aid.

Understanding Stroke Statistics

• Stroke Knowledge: It is important to know that approximately 13% of strokes are due to hemorrhage.

The Glasgow Coma Scale

• A scoring system to assess levels of consciousness; scores from 3 to 15 based on responses to eye opening, verbal commands, and motor responses.

Documentation Tips

• Document findings clearly: Include orientation status, speech clarity, cranial nerve function, strength, coordination, and responses.