psych nursing
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| Somatoform dirsorders definition | physical symptoms w/out medical cause. ****The physical symptom is connected to a pshycological conflict
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| Psychoanalitic theory believes that _____ lead to innefective personality development. | poor coping mechanism (deny, repress, or redirect anxiety)
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| Biologic theory | genetic predisposition
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| Dx | r/o no physical organic cause present. THe symptoms will determine the dx.
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| 5 types | 1. conversion 2. Hypochondrias 3. Dysmorphic disorders, 4. somatoform pain disorder 5. somatization disorder
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| Conversion | defense mechanism : convert amxiety into physical symptom. Usualy paralyses or blindness
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| onset for the convertion type | adolescents and early adulthood
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| in ther conversion type Denial is common. Why? | b/c symptoms allow the person to avoid what causes anxiety
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| primary gain | reliefe anxiety
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| secondary gain | feed from the support during the "sickness" (Sympathy, love, fincial benfits)
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| malingering | pretending to be sick for your own profitable gain. "faking"
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| munch housing by proxy | making someone else sick to profit from it
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| 2 type | hypocondriacs
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| Hypochondriacs are also called "professional patients" b/c .... | of the beleif and fear of becoming seriously ill. Constant preocupation that they are or will become serously ill and won't be able to get help. they are NOT faking
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| difference between Hypochondriac and conversion disorder pts. | conversion disorder = preocupied w/ symptoms. Hypochondriacs = preocupied w/ getting a serious dz
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| conversion | focus on a symptom
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| hypocondriacs | focus on the dz
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| 3rd type | Body dismorphic disorder (onset <30, usually teens)
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| what type of surgeries do these pts usually get? | cosmetic surgeries (usually facial)
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| 4th type |
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| Symptoms seen in somatization disorders | free-floating anxiety, emotional turmoil that manisfest as physical symptom ,pain that changes location, suicidal thoughts, depression
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| Why do these pt have unnecesary surgeies? | to remove the possible "cause" of the illness
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| 5th type: Somatoform pain disorder | more women more than men (hormonal)
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| incoherence between stated pain and ... | physical condition. (ex: may have an scruciating pain to a paper cut)
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| psychalgia | emotional pain that manifests as physical pain pain DOES NOT change location
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| S/S | psychalgia, pain not consistent w/ neuropaths, pain doesn't change location.
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| what is different about the pain in somatoform pain disorder and somatization disorder? | somatization = pain changes location. In this one pain DOESN'T change location
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| tx for somatoform disorders | hypnosis relaxation tecq, find underlying cause (stressor), stress managment, behavior modification
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| be careful w/ meds for these pts. Why? | these pts are already medicating themselves
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| DOC classification of Rx for somatoform disorders? | SSRI's
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| nrsg management | 1. honest communication that doesn't promisse cure and states the inability to find a life-threatening illness r/t to the pain expirienced. 2. therapy ( keep clients focus on other things). 3. support (pay attention to person but don't reinforce symptoms)
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| summary |
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| conversion disorder S/S | paralysis and blindness/ primary and secondary pain
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| nrsg intervention for conversion disorder | therapeutic communication / OT and PT / emotionla support
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| Hypochondriasis S/S | professional pt / fear of becomming ill / preocupied with being sick and not being helped
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| nrsg intervention for Hypochondriasis | don't reinforce symptoms / be nonjudgemental
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| body dysmorphic disorder | onset teens / preocupied with facil appearance or defect / OCD behaviors
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| nrsg interventions for body dysmorphic disorder | matter-of-fact intake of info / report all findings to MD
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| somatization disorder S/S | around 30 / 13 symptoms present out of 35 / free-floating anxiety/ emotional turmoil in physical symptoms / pain that changes location / depression and suicidal thoughts
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| nrsg intervention for somatization disorder | tx symptoms / assess underlying cx / maintain effective communication
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| somatoform pain disorder S/S | women/ teens/ psychalgia/ pain not consistent with findings / pain location unchanged
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| nrsg intervention for soatoform pain disorder | make sure pt knows there is no life-threatening condition and that staff will do their best to help pt.
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| All body related symptoms in SOMATOFORM DISORDERS are a result of ... | deeply rooted ANXIETY
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| the defense mechanisms used in SOMATOFORM DISORFDERS are | conversion and denial
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| what classification of drugs are given to these pts? | antienxiety and antidepressants
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| meds are usually given w/ ..... | caution (pts usually overmedicated)
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| drug names | Elavil, Welbutrin, Sinequan, Prozac (fluoxetin), Paxil, Zoloft (Sertraline), Desyrel
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