NSG 6020 Assignment: Altered Mental Status

NSG 6020 Assignment: Altered Mental Status

NSG 6020 Assignment Altered Mental Status

 

Discussed 3 differential diagnoses for altered mental status.

Identified risk factors, symptoms, any cultural influences, assessment, and diagnostic tools used to reach the diagnosis.

Used correct spelling, grammar, professional vocabulary, and APA format. Cited all sources using the APA format.

An alteration in mental status refers to general changes in brain function, such as confusion, amnesia (memory loss), loss of alertness, disorientation (not cognizant of self, time, or place), defects in judgment or thought, unusual or strange behavior, poor regulation of emotions, and disruptions in perception, psychomotor skills, and behavior. While an altered mental status is obviously characteristic of a number of psychiatric and emotional conditions, medical conditions and injuries that cause damage to the brain, including alcohol or drug overdose and withdrawal syndromes, can also cause mental status changes. Confusion, lethargy, delirium, dementia, encephalopathy, and organic brain syndrome are all terms that have been used to refer to conditions hallmarked by mental status changes.

NSG 6020 Assignment Altered Mental Status
NSG 6020 Assignment Altered Mental Status

Causes of Acutely Altered Mental Status. The mnemonic “MIST-P” is a useful way to help remember a long list of differential diagnoses and roughly divides the causes into three broad classes:

  1. a. Metabolic, Infectious, Inflammatory, and Inherited disorders—this broad group is responsible for most cases of altered mental status, most commonly resulting in delirium.

  2. b. Seizures and Structural problems (stroke/vascular disorders, Tumor, Trauma)—these are focal lesions.

  3. c. Psychiatric disorders.

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“METABOL”

      • Medicines: medications that are either directly psychoactive (e.g., benzodiazepines) or have significant cognitive side effects (e.g., anticholinergics)

      • Electrolyte derangements (e.g., disorders of sodium, magnesium, or calcium)

      • Endocrine disorders (increased or decreased levels of glucose, cortisol, thyroid hormone)

      • Temperature derangements (i.e., hypothermia or hyperthermia)

      • Alcohol and other drugs, either in toxicity or causing a withdrawal syndrome

      • B12 and other vitamin deficiencies, (e.g., niacin deficiency [pellagra] or thiamine deficiency [Wernicke-Korsakoff syndrome])

      • Oxygen deficiency or hypercarbia (oxygen deficiency may result from insufficient oxygen in the blood [i.e., hypoxemia], an inadequate number of red blood cells (RBCs) to carry the oxygen [i.e., anemia], or insufficient forward flow [i.e., decreased cardiac output])

      • Liver or kidney disease causing encephalopathy

    • Infectious disorders either affecting the central nervous system (CNS) directly (e.g., encephalitis, brain abscess, prion disease) or a distant/systemic site (e.g., sepsis, urinary tract infection)

    • Inflammatory (e.g., collagen vascular diseases, sarcoidosis, autoimmune encephalitis [such as anti-NMDA receptor encephalitis])

    • Inherited or degenerative diseases (e.g., Huntington’s disease, Alzheimer’s disease)

    • Seizures (actively seizing or due to a postictal state)

    • Strokes and other vascular disorders

      • Ischemic infarcts

      • Bleeds (epidural, subdural, subarachnoid, or intracerebral)

      • Hypertensive encephalopathy

      • Thrombotic thrombocytopenic purpura (TTP) or disseminated intravascular coagulation (DIC)

      • Hyperviscosity syndrome (seen with plasma cell dyscrasias or significantly elevated RBC counts)

    • Tumors: malignant processes may lead to altered mental status either because of an intracranial lesion or because of a paraneoplastic process

    • Trauma (e.g., concussion)

    • Psychiatric disorders

    • Porphyria

      NSG 6020 Assignment: Altered Mental Status Grading Rubric

      Performance Category 100% or highest level of performance

      100%

      16 points

      		 Very good or high level of performance

      88%

      14 points

      		 Acceptable level of performance

      81%

      13 points

      		 Inadequate demonstration of expectations

      68%

      11 points

      		 Deficient level of performance

      56%

      9 points

       

      		 Failing level

      of performance

      55% or less

      0 points
       Total Points Possible= 50           16 Points    14 Points 13 Points        11 Points           9 Points          0 Points
      Scholarliness

      Demonstrates achievement of scholarly inquiry for professional and academic topics.

      		 Presentation of information was exceptional and included all of the following elements:

      • Provides evidence of scholarly inquiry relevant to required TD topic(s).
      • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
      • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
      • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
      		 Presentation of information was good, but was superficial in places and included all of the following elements:

      • Provides evidence of scholarly inquiry relevant to required TD topic(s).
      • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
      • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
      • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
      		 Presentation of information was minimally demonstrated in all of the following elements:

      • Provides evidence of scholarly inquiry relevant to required TD topic(s).
      • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
      • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
      • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
      		  

      Presentation of information is unsatisfactory in one of the following elements:

      • Provides evidence of scholarly inquiry relevant to required TD topic(s).
      • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
      • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
      • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
      		  

      Presentation of information is unsatisfactory in two of the following elements:

      • Provides evidence of scholarly inquiry relevant to required TD topic(s).
      • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
      • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
      • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
      		 Presentation of information is unsatisfactory in three or more of the following elements

      • Provides evidence of scholarly inquiry relevant to required TD topic(s).
      • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
      • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
      • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information
       16 Points  14 Points  13 Points 11 Points 9 Points  0 Points
      Application of Course Knowledge

      Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations

      		 Presentation of information was exceptional and included all of the following elements:

      • Applies principles, knowledge and information from scholarly resources to the required topic.
      • Applies facts, principles or concepts learned from scholarly resources to a professional experience.
      • Application of information is comprehensive and specific to the required topic.
      		 Presentation of information was good, but was superficial in places and included all of the following elements:

      • Applies principles, knowledge and information from scholarly resources to the required topic.
      • Applies facts, principles or concepts learned from scholarly resources to a professional experience.
      • Application of information is comprehensive and specific to the required topic.
      		 Presentation of information was minimally demonstrated in the all of the following elements:

      • Applies principles, knowledge and information from scholarly resources to the required topic.
      • Applies facts, principles or concepts learned from scholarly resources to a professional experience.
      • Application of information is comprehensive and specific to the required topic.
      		 Presentation of information is unsatisfactory in one of the following elements:

      • Applies principles, knowledge and information from scholarly resources to the required topic.
      • Applies facts, principles or concepts learned from and scholarly resources to a professional experience.
      • Application of information is comprehensive and specific to the required topic.
      		 Presentation of information is unsatisfactory in two of the following elements:

      • Applies principles, knowledge and information from scholarly resources to the required topic.
      • Applies facts, principles or concepts learned from scholarly resources to a professional experience.
      • Application of information is comprehensive and specific to the required topic.
      		 Presentation of information is unsatisfactory in three of the following elements

      • Applies principles, knowledge and information and scholarly resources to the required topic.
      • Applies facts, principles or concepts learned scholarly resources to a professional experience.
      • Application of information is comprehensive and specific to the required topic.
         10 Points 9 Points  6 Points  0 Points
      Interactive Dialogue

      Initial post should be a minimum of 300 words (references do not count toward word count)

      The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count)

      Responses are substantive and relate to the topic.

      		 Demonstrated all of the following:

      • Initial post must be a minimum of 300 words.
      • The peer and instructor responses must be a minimum of 150 words each.
      • Responses are substantive
      • Responses are related to the topic of discussion.
      		 Demonstrated 3 of the following:

      • Initial post must be a minimum of 300 words.
      • The peer and instructor responses must be a minimum of 150 words each.
      • Responses are substantive
      • Responses are related to the topic of discussion.
      		 Demonstrated 2 of the following:

      • Initial post must be a minimum of 300 words.
      • The peer and instructor responses must be a minimum of 150 words each.
      • Responses are substantive
      • Responses are related to the topic of discussion.
      		 Demonstrated 1 or less of the following:

      • Initial post must be a minimum of 300 words.
      • The peer and instructor responses must be a minimum of 150 words each.
      • Responses are substantive
      • Responses are related to the topic of discussion.
        8 Points 7 Points  6 Points         5 Points          4 Points  0 Points
      Grammar, Syntax, APA

      Points deducted for improper grammar, syntax and APA style of writing.

      The source of information is the APA Manual 6th Edition

      Error is defined to be a unique APA error. Same type of error is only counted as one error.

      		 The following was present:

      • 0-3 errors in APA format

      AND

      • Responses have 0-3 grammatical, spelling or punctuation errors

      AND

      • Writing style is generally clear, focused on topic,and facilitates communication.
      		 The following was present:

      • 4-6 errors in APA format.

      AND/OR

      • Responses have 4-5 grammatical, spelling or punctuation errors

      AND/OR

      • Writing style is somewhat focused on topic.
      		 The following was present:

      • 7-9 errors in APA format.

      AND/OR

      • Responses have 6-7 grammatical, spelling or punctuation errors

      AND/OR

      • Writing style is slightly focused on topic making discussion difficult to understand.
      		  

      The following was present:

      • 10- 12 errors in APA format

      AND/OR

      • Responses have 8-9 grammatical, spelling and punctuation errors

      AND/OR

      • Writing style is not focused on topic, making discussion difficult to understand.
      		  

      The following was present:

      • 13 – 15 errors in APA format

      AND/OR

      • Responses have 8-10 grammatical, spelling or punctuation errors

      AND/OR

      • Writing style is not focused on topic, making discussion difficult to understand.

      AND/OR

      • The student continues to make repeated mistakes in any of the above areas after written correction by the instructor.
      		 The following was present:

      • 16 to greater errors in APA format.

      AND/OR

      • Responses have more than 10 grammatical, spelling or punctuation errors.

      AND/OR

      • Writing style does not facilitate communication
        0 Points Deducted 5 Points Lost
      Participation

      Requirements

      		Demonstrated the following:

      • Initial, peer, and faculty postings were made on 3 separate days
      		 Failed to demonstrate the following:

      • Initial, peer, and faculty postings were made on 3 separate days
        0 Points Lost 5 Points Lost
      Due Date Requirements Demonstrated all of the following:

      • The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT.

      A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.

      		Demonstrates one or less of the following.

      • The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT.

      A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.