WEEK ONE Flashcards
(29 cards)
Why would we give someone a mental status exam?
- objective description of the patient’s mental state
- correlates to head to toe assessment and should be done every day
- captures current mental state
- basis for psychiatric work
What information is captured in the general appearance portion of the MSE?
- gender & culture
- age
- attire
- grooming & hygiene
- physique/build
- eye contact, position & posture
- distinguishing features
What is captured in the behaviour portion of the MSE?
General observations
Behaviour
Motor Behaviour
If a patient is catatonic, how are they acting?
severe disturbance of motor function, usually manifested by markedly decreased activity, but may involve brief periods of hyperactivity
If a patient has tardive dyskinesia, how are they acting?
involuntary movements of tongue, face, extremities related to antipsychotic use
After moving a patient’s arm, they hold their arm in that position for an extended time. How would you describe their motor behaviour?
waxy flexibility
A patient has reliably taking scheduled antipsychotics. They report muscular tension. You observe them being restless, pacing, repeatedly sitting and standing. You are inclined to report that they are agitated. What could be a differential diagnosis?
Akathisia
What is captured in the speech portion of the MSE?
rate, rhythm, volume, amount, articulation, concerns
What is captured in the cognition portion of the MSE?
LOC, orientation, attention, concentration, memory, intelligence, impulse control, insight, judgement
What are some ways to assess concentration and attention?
- serial 7s
- name days/months backwards
- 3 word recall
What are some ways to assess memory?
remote events - long term
recent events - 24 hour diet
- 3 word recall
What is captured in the perceptions portion of the MSE?
Perceptual disturbances, hallucinations
If a patient misinterprets running water as hearing voices, how would you describe their perception?
illusions
If a patient describes their body as unfamiliar or this reality as unfamiliar, how would you describe their perception?
1 - depersonalization
2 - derealization
What is affect?
observed expression of emotion which is described in terms of its range and intensity, quality and appropriateness
What is mood?
subjective pervasive sustained emotion that tints the perception of the world
A patient tells you that they know all of the nurses in the nursing station are taking about him. How would you describe this thought content?
ideas of reference
A patient has the belief that they are secretly loved by Chris Pratt. What type of delusion are they experiencing?
erotomanic
A patient has the belief that the news anchor is specifically referring to them in their broadcast. What type of delusion are they experiencing?
reference
A patient has the belief they are the surgeon general. What type of delusion are they experiencing?
grandiose
A patient is talking in detail and at length around a point before finally getting to it. How would you receive their thought process?
circumstantial
A patient becomes side-tracked through a chain of readily available, understandable associations, but never answers your question. How would you describe their thought process?
tangential
A patient is rapidly changing from topic to topic based on understandable links between topics and is very easily distracted by external stimuli. How would you describe their thought process?
flight of ideas
A another nurse describes a patient’s thought process as tangential. When you speak to them they are shifting from idea to idea that have no related connections. How would you describe their thought process and why?
loose associations - no path between topics, they’re not related
