CONSIDERATION
MODULE 3
PREPARED BY:
MARY RUTH V. ENRIQUEZ, RN MAN
General Assessment
considerations
1. Principles and Techniques of the
Psychiatric Nursing Interview
2. Mental Status Examination (MSE)
3. Diagnostic Examination Specific to
Psychiatric Patient
ASSESSMENT:
PSYCHOSOCIAL
ASSESSMENT:
FACTORS INFLUENCING
ASSESSMENT
1)
2)
3)
4)
5)
1)
2)
3)
4)
ENVIRONMENT
The nurse should conduct the psychosocial assessment in an
environment that is comfortable, private, and safe for both the
client and the nurse.
An environment that is fairly quiet with few distractions allows
the client to give his or her full attention to the interview.
Conducting the interview in a place such as a conference
room ensures the client that no one will overhear what is
being discussed.
The nurse should not choose an isolated location for
interview, particularly if the client is unknown to the nurse or
has a history of any threatening behavior.
taking?
MENTAL STATUS
EXAMINATION
1. History
5. SENSORIUM AND
INTELLECTUAL PROCESSES
ORIENTATION
MEMORY
ABILITY TO CONCENTRATE
ABSTRACT THINKING & INTELLECTUAL
ABILITIES
ORIENTATION:
Refers to the clients recognition of person,
place, and time- that is , knowing who and where
he or she is and the correct day, date , and year.
MEMORY:
The nurse directly assesses memory, both
recent and remote by asking questions with
verifiable answers.
Ex.
What is the name of the current president?
Who was the president before that?
In what country do you live?
What is the capital of this state?
What is your social security number?
Verifiable answers : give accurate answers.
ABILITY TO CONCENTRATE:
The nurse assesses the clients ability to concentrate by
asking the client to perform certain tasks:
Spell the word WORLD backward: DLROW
Serial 7: begin with 100 subtract 7, subtract 7, again
and so on.
Repeat the days of the week backward: Sunday,
Saturday, Friday, Thursday, Wednesday, Tuesday,
Monday .
Perform a THREE-PART TASK, such as take a piece
of paper in your right hand, fold it in half, and put it on
the floor. ( The nurse should give the instructions at
one time)
Ex.
Proverb : A STITCH IN TIME SAVES TIME
ABSTRACT meaning: If you take the time to
fix something now, youll avoid bigger
problems in the future.
LITERAL translation: Dont forget to sew up
holes in your clothes (Concrete thinking)
6. JUDGMENT AND
INSIGHT
SELF- CONCEPT
Common questions:
Do you feel close to your family?
Do you have or want a relationship with a
significant other?
Are your relationships meeting your needs for
companionship or intimacy?
Can you meet your sexual needs satisfactorily?
Have you been involved in any abusive
relationship?
Assignment: