m m m m m m m m
DY GUIDE DOWNLOAD Score A+/RATED A+.
m mm m m m
Mental Health Exam 3 Concept Gu
m m m m m
ide (Modules 7, 8, 9)
m m m m m
Somatic Symptom Disorder- NON INTENTIONAL
m m m m
• people with this disorder are extremely persistently preoc
m m m m m m m
cupied with and distressed by their perceived health issue
m m m m m m m m
s
• demand unnecessary tests, noncompliant with provider recomme
m m m m m m
ndations
• significant life impairment, preoccupation and high anxiety
m m m m m m
• “doctor shopping” when they do not receive the answers fr
m m m m m m m m m
om physicians, undergo unnecessary surgeries, invasive dia
m m m m m m
gnostic procedures & drug trials
m m m m
• usually diagnosed with depressive and/or anxiety disorders
m m m m m m
Somatoform Disorder Nursing Interventions
m m m
• offer explanations and support-
m m m
m reduces anxiety (don’t reinforce illness)
m m m m
• avoid further reinforcement- direct focus away
m m m m m
• observe and record frequency and intensity of somatic symptoms
m m m m m m m m
- establishes baseline
m m
• DO NOT imply symptoms are not real (they are real to pts)
m m m m m m m m m m m
• Assess secondary gains m m
• Use straightforward approach- avoid power struggle
m m m m m
• Reinforce pts strengths and problem-solving abilities-
m m m m m
m contributes to positive self esteem m m m m
• Stress reduction- m
,NURS 2488 MENTAL HEALTH EXAM 3!!! BEST EXAM STU
m m m m m m m m
DY GUIDE DOWNLOAD Score A+/RATED A+.
m mm m m m
m provides alternative coping strategies and reduces need for meds
m m m m m m m m
Secondary Gains (for somatoform disorders)
m m m m
• Benefits derived from the symptoms alone. Ex: in the sick role,
m m m m m m m m m m m
patient is not able to perform normal family, work, and social f
m m m m m m m m m m m
unctions and receives extra attention from loved ones. If pts de
m m m m m m m m m m
rives personal benefit from the symptoms, relinquishing the sy
m m m m m m m m
mptoms is more difficult.m m m
• Approach to identifying presence of secondary gains is to ask que
m m m m m m m m m m
stions such as: m m
o What abilities have you lost since the development of your
m m m m m m m m m m
symptom(s) ? m
o How has this problem affected your life? Are there things y
m m m m m m m m m m
ou can no longer do?
m m m m
o Depending upon the individual patient and your rapport
m m m m m m m
, the nurse might gently approach whether there is anyt
m m m m m m m m m
hing positive obtained because of the disorder.
m m m m m m
Hypochondria’s (Illness anxiety disorder) Prominent health anxiety
m m m m m m
• Preoccupied with having or eventually developing a serious illness
m m m m m m m m
• May or may not present with somatic symptoms, and if so-
m m m m m m m m m m
m usually mild. m
o Unintentional and not under conscious control m m m m m
o Significant distress or dysfunction m m m
• Preoccupied with belief of having a devastating sickness or diseas
m m m m m m m m m
e
,NURS 2488 MENTAL HEALTH EXAM 3!!! BEST EXAM STU
m m m m m m m m
DY GUIDE DOWNLOAD Score A+/RATED A+.
m mm m m m
• Inability to function in personal, social, and occupational roles are
m m m m m m m m m m
often impaired m
Conversion disorder- m
m (also called Functional Neurobiological Symptom Disorder)
m m m m m
• Presents with one or more symptoms of impaired motor or sen
m m m m m m m m m m
sory functionm
• Incompatible or exaggeration of recognized neurological c
m m m m m m
onditions, not explained by another mental or medical diso
m m m m m m m m
rder
• Causes significant distress to the patient and impaired social or
m m m m m m m m m
m occupational functioning m
• Symptoms: (episodes are typically brief but may become chron
m m m m m m m m
ic)
o weakness or paralysis m m
o abnormal movement m
o swallowing or speech difficulties m m m
o seizures or attacks m m
o sensory loss or anesthesia
m m m
o symptoms involving the senses (blindness or loss of smel
m m m m m m m m
l)
• symptoms are not voluntarily controlled or created.
m m m m m m
• La bella indifference: patients who are highly distressed or show
m m m m m m m m m
m lack of emotional concern.
m m m
• Comorbidities include: childhood abuse, depression, a
m m m m m
nxiety and personality disorders Nursing intervention:
m m m m m
• Behavioral therapy m
, NURS 2488 MENTAL HEALTH EXAM 3!!! BEST EXAM STU
m m m m m m m m
DY GUIDE DOWNLOAD Score A+/RATED A+.
m mm m m m
• Family therapy m
• Hypnosis
• Anxiolytics- used to reduce anxiety m m m m
Dissociative Fugue- m
• patient in a fugue state frequently relocates and assumes a ne
m m m m m m m m m m
w identity while not recalling previous identity or places previ
m m m m m m m m m
ously inhabited. The distracters are more consistent with para
m m m m m m m m
noid schizophrenia, generalized anxiety disorder, or bipolar di
m m m m m m m
sorder
• rather lead simple lives not calling attention to themselves,
m m m m m m m m
m as time progresses the person may remember their forme
m m m m m m m m
r identity and then become amnesic of the time in the fugu
m m m m m m m m m m m
e state.
m
• USUALLY PRECIPITATED BY A TRAUMATIC EVENT
m m m m m
• Implementation: Dissociative disorders is treated in the co m m m m m m m
mmunity, but may be admitted to a psychiatric unit when
m m m m m m m m m m
suicidal or in need of crisis stabilization
m m m m m m
• Teaching: teaching about illness and instructions in coping skills
m m m m m m m m m
and stress management. Patients keep
m m m m
a daily journal to increase awareness of feelings and to identify tr
m m m m m m m m m m m
iggers
• Treatment: psychotherapy- m
m primary and most effective treatment. Therapy needs to be
m m m m m m m m
m flexible. Techniques include: m m
o Psychoeducation
o Processing memories and trauma through talking
m m m m m