Neurological Assessment in Psychiatric Nursing of Mental Health Patient

This is provide a clinical outline of Neurological assessment of mental health patient in Psychiatric Nursing,
Its involve how a psychiatric Nurse ot a Clinical Nurse should used the neurological assessment tools to evaluate a patient in required.

Neurological Examination

        I.            Level Of Conciousness

1. Alert / Lethargic / Stuporous / Semi-Comatose / Comatose

Score Of Glasgow Coma Scale:

      II.            Mental Status Examination

·         General Appearance

·         Speech

·         Thought  Process

·         Mood

·         Cognitive Function

-          Attention And Concentration

       Serial 7

       Digit Span – Backward, Forward

-          Orientation

Time

Place

Person

-          Memory

Immediate

Recent

Remote

-          General Knowledge

-          Abstract Reasoning

-          Judgement

-          Insight

Iii. Special Cerebral Function

·         Agnosia / Apraxia/ Aphasia

Iv. Cranial Nerve Examination

1.       Olfactory Nerve – Sense Of Smell – Present / Absent

2.       Optic Nerve – Inspection Of Eye –Inflamation / Cataract / Forgein Bodies / Any Abnormalities

-          Visual Acuity (Snellen ‘S Chart)

-          Visual Field Examination – Right Eye

                                                        Left Eye

-          Opsthalmoscope Examination

-          Color Vision – Present / Absent

          3.  Oculomotor, Trochlear And Abducent Nerve S

-           Pupillary Reaction To The Light – Reacting /Not Reacting

-          Pupillary Size – Equal / Unequal

-          Eye Movement  In Six Direction – Normal / Abnormal

-          Nystagmus – Present / Absent

-          Diploplia -  Present /Absent

4.  Trigeminal Nerve

-          Coroneal Reflex – Present / Absent

-          Facial Sensory Response- Present / Absent

-          Mandibular Strength- Adequate / Hpotonia

5. Facial Nerve

-   Facial Expression – Normal / Hypotonia

-   Taste Sensation – Present / Absent

6. Vestibular Cochlear Nerve

-          Auditory Acuity Test

-          Air Conduction

-          Bone Conduction

7. Glassopharengeal And Vagus Nerve

-          Gag Reflex – Present / Absent

-          Swallowing Refelex – Present/ Absent

-          Position And Movement  Of Uvulva And Palate – Normal Position / Deviation

-          Sensation Of Taste – Present / Absent

8.  Spinal Accessory Nerve

-          Stenocleidomastoid Muscle Strength- Normal  / Hypotonia

-          Elevation Of Shoulders – Adequate Strength / Weakness

-          Turning Of Head – Adequate / Inadequate

9. Hypoglossal Nerve

-          Tongue Movement – Norma L / Abnormal

V.Motor Function Assessment

-          Muscle Size

-          Muscle Strength

-          Muscle Tone

-          Muscle Co-Ordination

-          Gait

-          Movements Of All The Joints

-          Deformities

-          Abnormal Movement

Vi. Sensory Functionn Assessment

-          Pain Sensation : Present / Absent

-          Temperature Sensation :Present / Absent

-          Touch Sensation : Present / Absent

-          Vibration Sensation : Present / Absent

Vii. Assessment Of Cerebellar Function

1.       Finger To Finger Test -  Normal / Abnormal

2.       Finger To Nose Test- Normal / Abnormal

3.       Romberg Test – Normal / Unable To Perform

4.       Tandem Walking Test- Normal / Unable To Perform

Viii. Assessement Of Refelexes

1.       Superficial Reflexes- Present / Absent

Abdominal / Plantar / Corneal / Pharengeal / Creamasteric / Anal

2.       Deep Tendon Reflexes – Present / Absent

Bisceps / Triceps / Brachioradial / Patellar / Achilles

3.       Any Abnormal Reflexes- Present / Absent