Term
| for somatoform dissociation disorders, what is the primary nursing focus? |
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Definition
| on the physical manifestation of the disorders. |
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Term
| define somatoform disorders |
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Definition
• Physical symptoms suggest a physical disorder for which there is no demonstrable base.
• There is a strong presumption that the symptoms are linked to psychobiological factors. |
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Term
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Definition
| the expression of psychological stress through physical symptoms |
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Term
| why is the patient's history very important to help diagnose a somatoform disorder? |
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Definition
| often the disorders have a comorbid psychiatric disorder. somatoform disorders are sometimes hard to distinguish from real physical disorders |
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Term
| name 3 somatoform disorders currently recognized by the DSM-IV-TR |
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Definition
• Somatization disorder
• Undifferentiated somatoform disorder
• Conversion disorder
• Pain disorder
• Hypochondriasis
• Body dysmorphic disorder
• Somatoform disorder not otherwise specified |
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Term
| what is Somatization disorder |
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Definition
| Somatization disorder is the most common somatoform disorder (Yutzy & Parish, 2008). Diagnosis requires the presence of a certain number of symptoms accompanied by significant functional impairment. Pain, gastrointestinal symptoms, sexual symptoms, and pseudoneurological symptoms are hallmarks of this disorder. |
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Term
| people with somatization disorder are generally what type of person? |
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Definition
| more often female, nonwhite, poorly educated, of a low socioeconomic status, and from rural areas |
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Term
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Definition
| Persons with this disorder exhibit an overconcern for their health and become preoccupied with symptoms they believe may be serious. |
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Term
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Definition
| When testing rules out any organic cause for the pain, and the discomfort leads to significant impairment, pain disorder is diagnosed. |
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Term
| what is Body dysmorphic disorder |
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Definition
| Although patients usually have a normal appearance, their preoccupation with an imagined defective body part results in obsessional thinking and compulsive behavior, such as mirror checking and camouflaging. |
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Term
| what is Conversion disorder |
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Definition
| Conversion disorder is marked by the presence of deficits in voluntary motor or sensory functions, including paralysis, blindness, movement disorder, gait disorder, numbness, paresthesia, loss of vision or hearing, or episodes resembling epilepsy (Yutzy & Parish, 2008). Many patients show a lack of emotional concern about the symptoms (la belle indifférence), although others are quite distressed. |
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Term
| what is the most common somatoform disorder? |
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Definition
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Term
| which medical conditions are commonly confused with somatoform disorders, and thus need to be ruled out first? |
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Definition
• Multiple sclerosis
• Brain tumor
• Hyperthyroidism
• Hyperparathyroidism
• Lupus erythematosus
• Myasthenia gravis |
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Term
| during an assessment, why do you want to determine if symptoms are under the patients controls? |
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Definition
| because somatoform symptoms are not able to be voluntarily controlled. |
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Term
| what are "secondary gains"? |
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Definition
| are those benefits derived from the symptoms alone; for example, in the sick role, the patient is not able to perform the usual family, work, and social functions and receives extra attention from loved ones. If a patient derives personal benefit from the symptoms, giving up the symptoms is more difficult. |
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Term
| drug classes used to help patients with somatoform disorders |
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Definition
| SSRI's, TCAs, anti anxiety meds. |
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Term
| what is a factitious disorder |
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Definition
| pretending to be ill to get emotional needs met |
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Term
| what is Munchausen syndrome |
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Definition
| Munchausen syndrome is notable for the way patients go from one primary care provider or hospital to another, seeking attention. The severity of the symptoms is evident in the aggressiveness of treatments by clinicians. |
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Term
| what is factitious disorder by proxy (also known as Munchausen syndrome by proxy) |
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Definition
| a caregiver deliberately feigns illness in a vulnerable dependent, usually a child, for the purpose of the attention, excitement, and treatment by health care providers of that dependent. The caregiver frequently is a health care worker or someone with extensive knowledge of the health care system. |
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Term
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Definition
| Malingering is a consciously motivated act to deceive based on the desire for material gain (Sadock & Sadock, 2008). It involves a conscious process of fabricating an illness or exaggerating symptoms in order to become eligible for disability compensation, commit fraud against insurance companies, obtain prescription medications, evade military service, or receive a reduced prison sentence. |
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Term
| what has been identified as a possible source of the symptoms of factitious disorders? |
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Definition
| brain dysfunctions/disorders |
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Term
| what are Dissociative disorders ? |
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Definition
| disturbances in the normally well-integrated continuum of consciousness, memory, identity, and perception. Dissociation is an unconscious defense mechanism that protects the individual against overwhelming anxiety. Patients with dissociative disorders have intact reality testing; that is, they are not delusional or hallucinating. Mild, fleeting dissociative experiences are relatively common to all of us; for example, we say we are on “automatic pilot” when we drive home from work and cannot recall the last 15 minutes before reaching the house. |
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Term
| what is depersonalization disorder |
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Definition
| a persistent or recurrent alteration in the perception of the self while reality testing remains intact. The person experiencing depersonalization may feel mechanical, dreamy, or detached from the body. These experiences of feeling a sense of deadness of the body, of seeing oneself from a distance, or of perceiving the limbs to be larger or smaller than normal are described by patients as being very disturbing. |
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Term
| what is Dissociative amnesia? |
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Definition
| the inability to recall important personal information, often of a traumatic or stressful nature; this lack of memory is too pervasive to be explained by ordinary forgetfulness. |
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Term
| what is Dissociative fugue |
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Definition
| characterized by sudden, unexpected travel away from the customary locale and inability to recall one's identity and information about some or all of the past. In rare cases, an individual with dissociative fugue assumes a whole new identity. During a fugue state, individuals tend to lead rather simple lives, rarely calling attention to themselves. After a few weeks to a few months, they may remember their former identities and become amnesic for the time spent in the fugue state. Usually a dissociative fugue is precipitated by a traumatic event. |
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Term
| what is dissociative identity disorder (DID |
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Definition
| he presence of two or more distinct personality states that recurrently take control of behavior. Each alternate personality (alter) or subpersonality has its own pattern of perceiving, relating to, and thinking about the self and the environment |
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Term
| what is believed to be the main causes for dissociative identity disorder (DID |
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Definition
| severe sexual, physical, or psychological trauma in childhood predisposes an individual to the development of DID. |
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Term
| how much more common is it for women to have DID than men? |
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Definition
| it is 3-9x more common in females. it most often follows severe childhood sexual/physical abuse |
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Term
| DID is thought to be a way of avoiding |
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Definition
| severe stress and anxiety brought on by extreme situations |
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Term
1. A patient states she has been ill for several months with stomach pain, headache, and dizziness. A review of records shows that she has been tested repeatedly for various conditions, yet no clinical diagnosis has been found. She states her pain is “10 out of 10” on a scale of 1 to 10. She has been treated in the past for anxiety and depression. Which condition should the nurse anticipate?
1. Hypochondriasis
2. Somatization
3. Conversion disorder
4. Body dysmorphic disorder |
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Definition
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Term
2. The nurse is caring for a patient who has experienced the onset of a headache and has no history of headaches. When talking with the nurse, the patient states, “I am sure this is a brain tumor.” Which condition should the nurse anticipate?
1. Hypochondriasis
2. Somatization
3. Conversion disorder
4. Body dysmorphic disorder |
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Definition
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Term
3. A patient presents to the emergency department with a sudden onset of lower paralysis. Although the patient's wife is hysterical, the patient himself is calm and unemotional. All organic causes for the paralysis have been ruled out. Which condition should the nurse anticipate?
1. Hypochondriasis
2. Somatization
3. Conversion disorder
4. Body dysmorphic disorder |
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Definition
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Term
4. A patient has been diagnosed with Munchausen's syndrome. Which behavior should the nurse anticipate?
1. Tendency to frequent the same caregiver and use the emergency department at night
2. Exaggeration of symptoms with the intent of becoming eligible for disability compensation
3. Inability to recall important information related to a recent rape attempt
4. Attempts to make oneself ill and going from one hospital to another to call attention to oneself |
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Definition
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Term
5. The nurse is planning care for a patient with a somatoform disorder. Which intervention(s) would be appropriate? Select all that apply.
1. Have patient direct requests to varying nurses so they will become familiar with the patient's needs.
2. Objectively explain that the patient's symptoms are not real.
3. Teach assertive communication.
4. Shift focus from somatic concerns to feelings.
5. Spend time with patient only when summoned. |
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Definition
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