Mental Status physical Exam

Physical exam panic attacks

Patients with altered mental status can challenge medics. Managing such patients is fraught with pitfalls that can be medically and legally significant.

Scenario

You are called to a residence in an upscale neighborhood to assist police where a teenage party has been going on. No adults are present. Called by neighbors because of excessive noise, police found a young female, minimally responsive and possibly overdosed on ETOH/drugs, lying on a sofa and responding only to loud verbal and painful stimuli. Her responses to your questions consist mainly of curses, "Leave me alone, " and pushing you away. Her appearance and vital signs are as follows:

  • Hot, dry, pink skin;
  • Pulse: 126 bpm;
  • Respirations: 24/min.;
  • BP: 160/120;
  • Tympanic temperature: 100.5°F;
  • Uncooperative.

Patient Approach

A patient with an altered level of consciousness should be approached carefully and in a nonconfrontational manner. Patient rapport is essential to obtaining a thorough assessment.

Observation of the patient's surroundings may yield valuable clues. Is there evidence of ETOH or other drug ingestion, such as drug paraphernalia, empty bottles or telltale smells?

Assessment of the patient with altered mental status must include the following key elements:

1. Level of consciousness. Is the patient aware of his surroundings?
2. Attention. Is the patient able to focus or concentrate on one task at a time, or is he easily distracted?
3. Memory. Can the patient record data in the brain and repeat it at will? Thorough assessment of memory includes short-term memory, such as the ability to repeat a sequence of objects several minutes after they are first introduced, and long-term memory, such as the names and birth dates of family members or being able to repeat the alphabet.
4. Cognitive ability. Can the patient process abstract thoughts coherently, such as explaining, "Why can't pigs fly?" Can he perform simple math or word problems, such as "Subtract 7 from 100 as many times as you can, " or "Spell the word world backward?"
5. Affect and mood. Affect is an objective assessment of the patient's demeanor and reaction to stimuli, while mood is a more subjective assessment of the patient's emotional state. Are both of them appropriate for the patient's current situation?

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Q&A

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what questions are asked for a mental health exam? | Yahoo Answers

Trevor Mcdonald, stop trolling and being a jerk. I have seen your pathetic, cruel answers on other questions and I feel really sorry for you. You must have a really low self-esteem to have to spend your time putting other people down. Find something more constructive to do with your time.
Anyway... I can't really answer your questions without more information. It depends on exactly what they are looking for. Are they testing your judgment and reasoning? Have you been having hallucinations? If you are scheduled for an exam, you could ask your doctor what to expect.
Good luck, and don'…

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