Psychiatric Assessment and Mental Health Nursing (Chapter 8)

Flashcards covering terminology and concepts for clinical psychiatric assessments, including mood, thought processes, and cognitive functions.

Closed-ended questions

Questions that have direct answers, usually yes or no, such as 'Are you having pain?' or 'Did you take your medicine?'

Open-ended questions

Statements or questions that bring out more information and help build rapport, such as 'Tell me what brought you in today.'

Mood

The emotional state or how someone feels inside.

Effect (Affect)

The outward expression of emotion.

Blunted effect

A state where a patient is slow to respond, has minimal eye contact, a flat delivery, and a quiet, low tone of speech.

Flat effect

Shows no emotional or facial expression.

Inappropriate effect

An emotional expression that is inconsistent with the situation, such as laughing when talking about a death.

Broad effect

A full range of emotional expression, whether or not it is appropriate.

Restricted effect

A limited emotional expression that appears as a serious or somber demeanor.

Thought process

Described as the 'train tracks,' it is the path, flow, or way in which thoughts move (logical versus illogical).

Thought content

Described as what is 'inside the train,' it refers to the material, subjects, or specific thoughts themselves (e.g., realistic thoughts versus delusions).

Circumstantial thinking

When a patient beats around the bush with excessive detail but eventually returns to the point of the question.

Tangential thinking

When a patient goes off track and never returns to the original point or answer.

Loose associations

Disorganized and illogical thoughts where the things being discussed have very little in common.

Flight of ideas

Rapid shifting speech where the patient starts one story and follows with many other stories that make no sense together.

Word salad

A jumble of words that make absolutely no sense together.

Delusion

A fixed false belief that a patient holds even when there is no evidence for it, such as believing there are space aliens outside.

Ideas of reference

The belief that external messages, such as those on TV, the radio, or street signs, are specifically about the individual.

Thought broadcasting

The belief that others can hear or read your thoughts.

Thought withdrawal

The belief that one's thoughts are being taken away.

Thought insertion

The belief that someone else is putting thoughts into your head or brainwashing you.

Duty to warn

A legal obligation to breach confidentiality to protect a patient from themselves or to notify a threatened person if there is an identifiable victim and a specific intent or plan.

Suicidal ideation

The state of thinking about killing oneself, which requires assessment of plans, access, and timing.

Orientation

The assessment of cognitive function based on knowledge of person, place, time, and situation.

Serial sevens

A concentration test that requires a patient to count back from $100$ by $7$.

Abstract thinking

The ability to look beyond the obvious and interpret meanings, such as understanding that 'a stitch in time saves nine' means fixing a problem now to prevent a bigger one later.

Concrete thinking

A literal style of thinking where the person only understands the obvious, such as interpreting 'don't cry over spilled milk' to mean literally that one should not cry if milk spills.

Hallucination

A false perception in any of the five senses, such as seeing, hearing, feeling, or smelling something that is not actually there.

Judgment

Analogous to a 'steering wheel,' it is the ability to interpret the environment and situation to make decisions and behaviors based on social norms.

Insight

Analogous to a 'dashboard,' it is the understanding of one's own situation, illness, and the personal responsibility for treatment.

DSM-5-TR

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision, which classifies and provides criteria for diagnosing mental health disorders.