Components of MSE - Psychiatric

Question 1

What is MSE?

Answer 1

MSE represents a cross section of the patient psychological life and the nurse’s observation and impressions at one point in time.

Question 2

Appearance

Answer 2

Looking at age, manner of dress, cleanliness, posture, facial expression, hygiene, odor, gait, eye contact, pupil dilation or constriction.

Question 3

speech

Answer 3

Rate- rapid or slow
Volume- loud of soft
Amount- paucity, muteness, pressured speech,, poverty
Characteristic- stuttering, slurring of words, or unusual accents

Question 4

Motor Activity

Answer 4

Level of activity 
Lethargic, tense, restless, agitated. 
Type of activity: tics, grimaces, tremors 
Unusual gestures or mannerisms 
Compulsive behavior

Question 5

Interaction

Answer 5

Is the patient hostile, uncooperative, irritable, guarded, apathetic, defensive, suspicious, seductive.

Question 6

Mood and Affect

Types of Affect

Answer 6

Mood- is the patient’s apparent self report of one’s emotional state and reflects the patients life situation.
Affect- is the patient’s apparent emotional tone. The pts statement of emotions and the nurse’s empathic response provide clues to the appropriate of the affect.
Affect- Range, duration, intensity, appropritateness
Types of Affect:
Flat affect- is the absence of emotional expression
Labile Affect- frequent changes from one affect to another.
Inappropriate Affect- emotions demonstrated is not congruent to the context.
Broad Affect- emotions of a psychologically healthy individual.
Restricted or Limited Affect- is the limited range of affect that a person can demonstrate.
Blunt affect- this is when restricted affect becomes more severe and when the expression of emotion becomes even more absent.

Question 7

Perceptions

Answer 7

2 major types: Hallucinations and illusions
Hallucinations are defined ad false sensory impressions or experiences.
Illusions are false perceptions or false responses to a sensory stimulus.
Hallucinations may occur in any of major sensory modalities such as auditory, visual, tactile, gustatory, olfactory.

Question 8

Thought Content

Answer 8

is the specific meaning expressed in the patients communication. It refers to “What” of the patient’s thinking.
Erotomania- excessive sexual behaviors.
Paranoid- Others are out to get him/her
Nihilistic- delusional belief that some part of body is a disease or rotten.
Somatic- false belief that a person’s internal or external bodily functions are abnormal.
Ideas of reference- delusional belief that an event externally relevant to him/her.
Grandoise- belief of one’s own greatness or skills.
Persecutory- convinced that someone is mistreating, conspiring against, or planning to harm you or your loved one.
Folie a deux- both person belief, psychiatric syndrome in which symptoms of a delusional belief, and sometimes hallucinations, are transmitted from one individual to another.
Thought broadcasting- belief that his/her thoughts shared with public eg: stop it tyrell.
Thought insertion- belief that people are trying to insert thoughts in his/her brain
Depersonalization- personal belief that body is an object. Eg: My leg is a wood leg.
Magical Thinking- belief that thinking equals to doing.

Question 9

Thought Process

Answer 9

relates to the “how” of the patient’s self expression. This is observed through speech. The pattern of forms of verbalization rather than the contents are assessed.
Such as: Circumstantial (excessive and unnecessary detail)
Flight of ideas- shifts from 1 topic to another
Looseness of association: lack of logical relationship between thoughts and ideas
Neologism- new words created by pt
Tangential- person never returns to central point or question/answer.
Thought blocking- sudden halt in train of thought.
Word salad- series of unrelated words.
Perseveration- involuntary, excessive continuation or repetition of a single response idea.

Question 10

Level of Consciousness

Answer 10

MSE routinely assess a pt’s orientation to the current situation.
Time, Person, Place

Question 11

Memory

Answer 11

ability to recall past experiences.
Remote memory- recall of events, info, people from the distant past.
Recent memory- recall of events, info, people from the past week or so.
Immediate memory- recall of events, info, people that was just exposed.

Question 12

Level of Concentration & Calculation

Answer 12

concentration- pt’s ability to pay attention during the course of the interview
Calculation- person’s ability to do simple math (serial 3’s or 7’s)

Question 13

Judgement

Answer 13

involves making decisions that are constructive and adaptive. Ability to understand facts and draw conclusions

Question 14

Insight

Answer 14

Pt’s understanding of the nature of one’s problem or illness.