20 Somatic Symptom and Related Disorders

Question 1

clients w somatic symptom are often encountered in which setting?

Answer 1

Primary care setting

-they often reject psych reasons and seek care fr several providers

Question 2

characteristics of chronic manifestations

Answer 2

• can be vague or exaggerated
• usually chronic but can be acute
• periods of remission + exacerbation

Question 3

common comorbidities

Answer 3

anxiety + depression

Question 4

somatic symptom

risk factors

Answer 4

• 1st degree relative w somatic symptm disordr
• decr neurotransmttrs: serotonin + endorphins
• depressive, personality, or anxiety disorder
• childhood trauma, abuse, or neglect
• learned helplessness

Question 5

somatic symptom

expected findings

Answer 5

• disrupted daily life bc smtc mnftsn
• excessive preoccupatn w smtc mnftsn
• incr level of anxiety bc of smtc mnftsn
• smtc mnftsn are present for at least 6 mos
• probable ETOH + substance abuse
• overmedicatn w anagesic or antianxiety
• high utilization of health services + multiple health care providers

Question 6

somatic symptom

nursing care

Answer 6

• accept smtc mnftsn as real for pt
• assess for suicidal/self harm
• report new phys mnfstn
• limit time allowed to discuss smtc mnftsn
• encourage independence in self care
• encourage verbalizatn of feelings
• educate alternative coping mechanism
• assertive technique
• daily exercise

Question 7

reattribution treatment

Answer 7

assist pt to ID the link bw phys manifestation + psych factors

Question 8

4 stages of reattribution treatment

Answer 8

1 feeling understood
2 broadening agenda
3 making the link
4 negotiating further treatment

Question 9

stage 1 feeling understood

Answer 9

use therapeutic communication, active listening, + empathy to obtain a thorough hx of manifest while focusing on perception of manifestatn + cause
-incl brief phys assessment

Question 10

stage 2 broadening agenda

Answer 10

provide acknowldgmt of pt’s concerns + provide feedback about assessment findings

Question 11

stage 3 making the link

Answer 11

acknowledge lack of physical cause while allowing pt t maintain self-esteem

Question 12

stage 4 negotiating further treatment

Answer 12

work w provider + pt to develop a tx plan that allows for reg follow up visits

Question 13

case manager will…

Answer 13

develop follow up appt w provider Q4-6wk

-decr the need for unscheduled health care as well as medical cost

Question 14

illness anxiety disorder

Answer 14

misinterprets phys manifestation as evidence of a serious disease process
-can lead to obsessive thoughts + fears about illness

Question 15

illness anxiety disorder aka

Answer 15

hypochondriasis

Question 16

illness anxiety disorder

characteristics

Answer 16

• overly aware of bodily sensations + attribute them to a serious illness
• preoccupation about having an undiagnosed serious illness
• research their suspected disease excessively + examine themselves repeatedly
• seek numerous medical opinions or avoid seeking health care to avoid anxiety
• continues to have anxiety despite negative diagnostic tests

Question 17

illness anxiety disorder

RF

Answer 17

• 1st degree relative w illness anxiety disorder
• previous loss/disappointment resulting in anger, guilt, or hostility
• childhood trauma, abuse, neglect
• depressive or anxiety disorder
• major life stressor
• low self esteem

Question 18

illness anxiety disorder

expected findings

Answer 18

• excessive anxiety that a serious illness is present or will be acquired
• -present for than 6 mos
• preoccupied w performance of behavrs that are health related (like breats check exam)

Question 19

2 types of illness anxiety disorder

Answer 19

1 health seeking type

2 care avoidant type

Question 20

illness anxiety disorder nursing care

Answer 20

• build rapport + trust

- encourage independence in self care