Which of the following is the most basic function and therefore should be tested first in assessment of mental status?
The Mental Status Exam (MSE)In actual practice, providers (with the exception of a psychiatrist or neurologist) do not regularly perform an examination explicitly designed to assess a patient's mental status. During the course of the normal interview, most of the information relevant to this assessment is obtained indirectly. This review provides an opportunity to consciously think of the elements contained within the MSE. Show
In the day to day practice of medicine (and, in fact, throughout all of our interactions) we continually come into contact with persons who have significantly impaired cognitive abilities, altered capacity for memory, disordered thought processes and otherwise abnormal mental status. First and foremost, the goal is to be able to note when these abnormalities exist (you'd be surprised at how frequently they can be missed) and then to categorize them as specifically as possible. If a person seems "odd, confused or not quite right" what do we mean by this? What about their behavior, appearance, speech, etc. has lead us to these conclusions? In some instances, the patient's condition (e.g. markedly depressed level of consciousness, intoxication) will preclude a complete, ordered evaluation of mental status, so flexibility is important. Knowing when to "cut your losses" and abandon a more detailed examination obviously takes a bit of experience! The formulation of actual diagnoses, the final step in this process is, for the most part, beyond the scope of this discussion (I've included two of the most commonly encountered ones at the end of this section as examples). In fact, even if you had the experience and knowledge to generate diagnoses, this still may not be possible after a single patient encounter. The interview provides a "snap shot" of the patient, a picture of them as they exist at one point in time. Frequently, and this applies to the physical examination as well, several interactions are required along with information about the patient's usual level of function before you can come to any meaningful conclusions about their current condition. The components of the MSE are as follows:
Diagnoses are made on the basis of a pattern of responses to the above evaluation. Two commonly occurring disorders are described below:
The Mini Mental Status Examination (MMSE) is a brief bedside test that is an excellent means of quantifying cognitive function and decline. A newer validated tool for quantifying cognitive performance is the Saint Louis University Mental Status Examination (SLUMS). Many aspects of the MSE are extremely subjective. There is tremendous potential for our own cultural exposure and background to color these assessments. Realize that there is a major distinction between "different" and "abnormal." Proverbs, for example, are not necessarily a part of any communal experience. Thus, a "failure" to provide a correct interpretation may in fact have nothing to do with an individual's intellectual function but rather may simply reflect a different upbringing or background. Similarly, tests of memory which require the subject to recite past U.S. Presidents may not be an appropriate measuring tool depending on a person's country of origin, language skills, educational level, etc. These situations are unavoidable in the extremely diverse community in which we live. Quantifying and defining the nature of a specific abnormality is an important part of the practice of medicine. While it is reasonable to expect that people be aware of certain basic facts (e.g. their name, the year, the purpose of their visit to the hospital, etc.) it is also important to recognize that our observation and interpretation of patient behavior and responses is colored by our own life experiences. Which of the following is the most basic function and therefore should be tested first in an assessment of mental status quizlet?Which of the following is the most basic function and therefore should be tested first in an assessment of mental status? Answer: B. According to your textbook, consciousness is the most fundamental of these particular characteristics; therefore, it would be tested first.
Which component would the nurse assess first when taking vital signs?Which component would the nurse assess first when taking vital signs? The radial pulse is taken first.
When meeting a patient for the first time it is important to establish a baseline assessment that will enable a nurse to refer back to?When meeting a patient for the first time, it is important to establish a baseline assessment that will enable a nurse to refer back to what? A pattern of findings identified when the patient is first assessed.
Which assessment is performed first while the nurse initiates the general survey?Which assessment is performed first while the nurse initiates the nurse-patient relationship? The first part of the general survey is assessment of the appearance and behavior of the patient.
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