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If safety is a concern, have a discussion with the older adult’s ______ or friend to encourage changes that will improve safety.
family member
The Mini-Cog assessment instrument combines an uncued three-item recall test with a ______ test.
clock-drawing
The Mini-Cog can be administered in about three minutes, requires no special equipment, and is relatively uninfluenced by level of ______ or language variations.
education
The CDT serves as the recall ______.
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A score of 1 or 2 with a normal CDT indicates ______ screen for dementia.
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______ may indicate a cerebral disorder.
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Five to eight numbers or words forward or four to six numbers or words backward can usually be ______.
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Impaired memory occurs with various neurologic or psychiatric ______.
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Loss of immediate and recent memory with retention of remote memory suggests ______.
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When a patient is visually impaired, test recent memory with unrelated words rather than observed ______.
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When assessing the patient's mental status, attempt to determine the patient's ability to perform the following ______: Shop, cook, and prepare nutritious meals, Use problem-solving skills, Manage medications, Manage personal finances and business affairs, Speak, write, and understand spoken and written language, Remember appointments, family occasions, holidays, household tasks.
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Depression, one of the most common conditions in older adults, may contribute to cognitive impairment. Depression can be identified with the Geriatric Depression Scale (Fig. 7.8). Paranoid thought may be a striking alteration in personality. Attempt to determine whether the thought process is accurate or a paranoid ideation, keeping in mind the incidence of elder ________.
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Facial expressions that are masklike or overly dramatic, or a stance that is stooped and fearful, may indicate a progressive disease in the older adult. Patient Safety Older Adult's Living Arrangements When impairment in the ability to perform ADLs is identified, determine safety in the older adult's living arrangements. Is a caregiver present in the home or does someone check in each day? Is food delivered to the home or are meals provided? Are medication dosages provided or ________?
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Has the older adult stopped driving a ________?
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Older adults are expected to maintain the same level of interpersonal skills and have no personality changes. Depression, one of the most common conditions in older adults, may contribute to cognitive impairment. Depression can be identified with the Geriatric Depression Scale (Fig. 7.8). Paranoid thought may be a striking alteration in personality. Attempt to determine whether the thought process is accurate or a paranoid ideation, keeping in mind the incidence of ________.
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Impairment of arithmetic skills may be associated with ______, cognitive impairment, and diffuse brain disease.
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Omission or addition of letters, syllables, words, or mirror writing may indicate ______ (impairment in language function).
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Uncoordinated writing or drawing may indicate dementia, parietal lobe damage, a cerebellar lesion, or ______ neuropathy.
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If safety is a concern, have a discussion with the older adult’s ______ or friend to encourage changes that will improve safety.
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The Mini-Cog assessment instrument combines an uncued three-item recall test with a ______ test.
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An inability to describe similarities or differences may indicate a lesion of the left or dominant ______ hemisphere.
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Signs of possible cognitive impairment include significant memory loss, confusion, impaired communication, inappropriate affect, personal care difficulties, hazardous behavior, agitation, and ______.
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Interview a family member or friend of the patient if you have any concerns about a patient’s responses or behavior to determine whether the patient has any problems remembering appointments or important events, paying bills, shopping independently for food or clothing, preparing meals, taking medication, getting lost while walking or driving, making decisions about daily life, or asking the same thing again and again. This is important for assessing the patient's ability to perform ______.
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If safety is a concern, have a discussion with the older adult’s caregiver or friend to encourage changes that will improve ______.
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The Mini-Cog can be administered in about three minutes, requires no special equipment, and is relatively uninfluenced by level of education or language variations. It is a useful tool for assessing the patient's ______ status.
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Five to eight numbers or words forward or four to six numbers or words backward can usually be ______.
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The CDT serves as the recall ______.
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______ may indicate a cerebral disorder.
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Loss of immediate and recent memory with retention of remote memory suggests ______.
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When a patient is visually impaired, test recent memory with unrelated words rather than observed ______.
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A score of 1 or 2 with a normal CDT indicates ______ screen for dementia.
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Has the older adult stopped driving a ______?
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The Mini-Cog can be administered in about three minutes, requires no special equipment, and is relatively uninfluenced by level of ______ or language variations.
Signup and view all the answers
Impaired memory occurs with various neurologic or psychiatric ______.
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When assessing the patient's mental status, attempt to determine the patient's ability to perform the following ______: Shop, cook, and prepare nutritious meals, Use problem-solving skills, Manage medications, Manage personal finances and business affairs, Speak, write, and understand spoken and written language, Remember appointments, family occasions, holidays, household tasks.
Signup and view all the answers
When assessing the patient's mental status, attempt to determine the patient's ability to perform the following ______: Shop, cook, and prepare nutritious meals, Use problem-solving skills, Manage medications, Manage personal finances and business affairs, Speak, write, and understand spoken and written language, Remember appointments, family occasions, holidays, household tasks.
Signup and view all the answers
If safety is a concern, have a discussion with the older adult’s ______ or friend to encourage changes that will improve safety.
Signup and view all the answers
Impaired memory occurs with various neurologic or psychiatric ______.
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Is a caregiver present in the home or does someone check in each day? Is food delivered to the home or are meals provided? Are medication dosages provided or ________?
Signup and view all the answers
Facial expressions that are masklike or overly dramatic, or a stance that is stooped and fearful, may indicate a progressive disease in the older adult. Patient Safety Older Adult's Living Arrangements When impairment in the ability to perform ADLs is identified, determine safety in the older adult's living arrangements. Is a caregiver present in the home or does someone check in each day? Is food delivered to the home or are meals provided? Are medication dosages provided or ________?
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Study Notes
Assessing Mental Status
- The Mini-Cog assessment instrument combines an uncued three-item recall test with a clock-drawing test (CDT) to evaluate cognitive function.
- The Mini-Cog takes approximately three minutes to administer, requires no special equipment, and is relatively uninfluenced by education or language variations.
Mini-Cog Administration
- Instruct the patient to remember three unrelated words and then repeat the words.
- Ask the patient to draw the face of a clock, including numbers and hands, and set the time to a specific hour (e.g., 11:20).
- After the CDT, ask the patient to repeat the three previously presented words.
- Score 1 point for each recalled word after the CDT distractor.
- A score of 0 indicates a positive screen for dementia.
Abstract Reasoning
- Ask the patient to explain the meaning of a fable, proverb, or metaphor (e.g., "A stitch in time saves nine").
- Inability to explain may indicate cognitive impairment.
Arithmetic Calculation
- Ask the patient to perform simple arithmetic without paper and pencil (e.g., subtract 7 from 50, add 8 to 50).
- Impairment in arithmetic skills may be associated with depression, cognitive impairment, and diffuse brain disease.
Writing Ability
- Ask the patient to write their name and address, a dictated phrase, or simple geometric figures (e.g., triangle, circle, square).
- Omission or addition of letters, syllables, words, or mirror writing may indicate aphasia or dementia.
Execution of Motor Skills
- Ask the patient to perform a simple motor task (e.g., unbutton a shirt button, comb their hair).
- Apraxia (inability to translate intention into action) may indicate a cerebral disorder.
Memory
- Immediate recall or new learning: Ask the patient to repeat a sentence or series of numbers.
- Recent memory: Ask the patient to recall four or five test objects viewed 10 minutes earlier.
- Remote memory: Ask the patient about verifiable past events or information (e.g., sibling's name, high school attended).
- Memory loss may result from disease, infection, or temporal lobe trauma.
Patient Safety
- Determine the patient's ability to perform activities of daily living (ADLs) such as shopping, cooking, managing medications, and managing finances.
- Identify safety concerns in the patient's living arrangements, such as the presence of a caregiver or daily check-ins.
Attention Span
- Ask the patient to follow a short set of commands or say the days of the week.
- Alternatively, ask the patient to spell a word forward or backward.
- Impaired attention span may be related to fatigue, depression, delirium, or toxic or metabolic causes.
Judgment
- Determine the patient's judgment and reasoning skills by exploring their social and family obligations, plans for the future, and ability to provide solutions to hypothetical situations.
- Signs of possible cognitive impairment include significant memory loss, confusion, impaired communication, and hazardous behavior.
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Description
Learn about assessing a patient's mental status by determining their ability to perform activities of daily living (ADLs) such as shopping, cooking, managing medications, personal finances, problem-solving skills, communication, and memory. This quiz focuses on evaluating crucial aspects of a patient's independence and cognitive functioning.
