Brain Trauma, Orientation

Visual or tactile hallucinations are often linked to organic conditions. These conditions may include drug intoxication or withdrawal, brain trauma, or brain disease.

Clients in acute delirious states may pick at their clothes or skin in an effort to remove 228 Structuring and Assessmentobjects or organisms they believe are producing their sensory experiences.

Similarly, clients may reach out or call out for people or objects that do not exist. Obviously, when clients report such experiences or you observe clients as they experience such perceptual disturbances, the disorder is usually of a very serious nature. Immediate medical evaluation and intervention is warranted.

Orientation and Consciousness

Mental status examiners routinely evaluate whether clients are oriented to their current situation. The question of whether a client is oriented involves evaluating basic cognitive functions. The examiner asks a client three simple questions: What is your name? Where are you ? What is today’s date? When a client answers these queries correctly, the examiner might write in the progress notes that the client was “OX3″ , referring to the fact that the client is aware of who and where he or she is, and what day it is. Evaluating a client’s orientation is a direct way to assess level of confusion or disorientation. Extremely disturbed clients may not be able to respond accurately to one or more of these simple questions. Resisting questions about orientation may indicate disorientation. In the following example, a hospital patient with a recent head trauma was interviewed regarding orientation: Interviewer: “I’m going to ask you a few questions that may seem a bit strange.