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Sensory-Neurological assessments


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For children under 5 years of age, what test do you use?
Denver Developmental Screening Test II
When assessing orientation of the client, what should they at least be aware of?
They may not be aware of the time of day but they should at least know the year. They should also know that ehy are in the hospital, and that you are a healthcare worker.
what type of orientation remains intact the longest?
what is the average series of recall of numbers?
5-8 numbers, and 4-6 numbers in reverse order.
In children, how would you rate number recall?
the number of objects recalled is usually fewer that the childs age.
How fast can the average adult perform serial sevens?
90 seconds with 3 or fewere errors
how would you assess abstract thinking?
as them to interpert a proverb such as "a penny saved is a penny earned"
at what age does the ability to think abstractly develope?
not until late school age years or adolescence.
How do you assess abstract thinking in a child under 12 years of age?
as them to describe things that are like and unlike.
How do you test spontaneous speech?
show them a picture and have them describe it
how do you test motor speech?
have the clietn say do re me fa so la ti do
how do you test automatic speech?
have the clietn recite the days of the week
What are the basic functions of the nervous system?
cognition, emotion, memory, sensation and perception, regulation of homeostasis.
On a patient who has no neurological problems,and you are performing a comprehensive exam, what aproach should you take?
perform a focused exam that looks at each of the areas in teh neurological exam. ....the reason is that it would take hours to compelte otherwise.
In clients with actual documented, neurological problems, what kidnof exam would you perform?
comprehensive, and compare to previous findings.
What does a neurological exam assess?
Cerebral function through evaluation of level of consciousness, mental status, and cognitive function Cranial nerve function through assessment of each of the 12 cranial nerves Reflex function through assessment of DTRs and superficial reflexes Sensory function through assessment of light touch, light pain, temperature, vibration, position sense, stereognosis, graphesthesia, two-point discrimination, point localization, and extinction Motor and cerebellar function through musculosketal assessment
What is cerebral function? What does it include?
its teh clients intellectual and behavioral functioning. It includes level of consciousness, mental status, and congnitive function and communication.
What is LOC? What does it include?
level of consciousness. It includes arousal and orientation.
How is arousal classified?
It is based on the type of stimuli required to produce a response from a client.
What would an Alert patient respond to? How would you document?
responds to auditory stimuli. Document that they follow commands in a timely fashion.
How would you describe a lethargic person?
appears drowsy, easily drifts off the sleep.
How would you describe a stuporous patient?
requires vigorous stimulation before responding.
How would you describe a comatose patient?
does not respond to verbal or painful stimuli
If the client does not respond to auditory stimuli what should you do next?
try tactile stimuli begining with gentle touch. If the dont respond to that, shake their shoulder
If a client does not respond to tactile stimuli what should you do next? (describe the methods of doing it too)
turn to painful stimuli. This would include squeezing their trapezius muscle, rubbing on the sternum, putting pressure on the mandible, or putting pressure over the moon of the nail. If they respond, they will withdraw when pressure is applied.
How do you document LOC?
based on the Glasgow Coma Scale.
Describle the Glasgow coma scale:
it observes eye, motor and verbal response and documents them with a numerical score. 4 or 5 is the best and 1 is no response.
When looking for a clients orientation, what 3 things should they be able to orient to?
time, place and person.
What does time orientation include? How might older clients and pshychotic clients respond?
it includes awareness of the year, date and time of day. Older adults may think its a much earlier year. Psychotic patients may think its the future or give a bazarre time.
What does orientation to place involve?
awareness of surroundings..for example knowing that they are in the hospital and not a church. .
What does orientation to person involve?
they should be able to state their own name and recognize people in photographs.
What do mental status and cognitive function include?
behavior, speech, appearance, response to stimuli, memory, communication and judgement.
What are normal findings when assessing mental status and cognitive function?
they should be able to: express realistic thoughts with clear speech follow multistep directions listen answer questions recall significant past events
what are reflexes?
automatic responses that do not require conscious thought from the brain...the response occurs at the level of the spinal cord, so it never actually travels to the brain and back.
how do you test sensory funtion?
have them keep their eyes closed as you apply various stimuli.
the ability to recognize the form of solid objects by touch.
the ability to recognize outlines, numbers, or symbols written on the skin.
what part of the brain helps coordinate muscle movement, tone and maintains your posture and equilibrium?
the cerebellum
body positioning.
what would disorders with motor or cerebellar funtiong result in?
pain or problems with movement, gait or posture.

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