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Psych Nursing > Ch 20 > Flashcards

Ch 20 Flashcards

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1
Q

An individual who is diagnosed with Adjustment Disorder with Disturbance of Conduct most likely:

A

violates the rights of others to feel better

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2
Q

are characterized by physical symptoms suggesting medical disease but without demonstrable organic pathology or a known pathophysiological mechanism to account for them

A

somatic symptom disorders

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3
Q

defined by a disruption in the usually integrated functions of consciousness, memory, and identity
very RARE

A

dissociative disorders

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4
Q

somatic symptom disorders are more commonly found in

A

Women than in men
Less educated persons
Rural areas

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5
Q

Brief episodes of _____ _____ appear to be common in young adults, particularly in times of severe stress.

A

depersonalization symptoms

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6
Q

A syndrome of multiple somatic symptoms that cannot be explained medically and is associated with psychosocial distress and long-term seeking of assistance from health-care professionals
“doctor shopping”

A

somatic symptom disorder

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7
Q

what is frequently manifested in somatic symptom disorder

A

is chronic, and anxiety, depression, and suicidal ideation

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8
Q

common complications of somatic symptom disorder

A

Drug abuse and dependence

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9
Q

personality characteristics of somatic symptom disorder

A

Heightened emotionality, strong dependency needs, and a preoccupation with symptoms and oneself

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10
Q

describe somatic symptom disorder

A

symptoms cannot be explained medically
associated with psychosocial distress
similar to hypochondriac

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11
Q

Unrealistic or inaccurate interpretation of physical symptoms or sensations, leading to preoccupation and fear of having a serious disease

A

illness anxiety disorder

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12
Q

describe illness anxiety disorder

A

The behavioral response to even the slightest changes in feeling or sensation is unrealistic and exaggerated.
Anxiety and depression are common, and obsessive-compulsive traits frequently accompany the disorder.
does not go “doctor shopping”

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13
Q

A loss of or change in body function that cannot be explained by any known medical disorder or pathophysiological mechanism.

A

conversion disorder

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14
Q

The most obvious and “classic” conversion symptoms are those that

A

suggest neurological disease

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15
Q

Some instances of conversion disorder may be precipitated by

A

psychological stress.

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16
Q

when dealing with somatic disorders what should always be considered first

A

physical concerns before mental concerns

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17
Q

Conscious, intentional feigning of physical and/or psychological symptoms
Individual pretends to be ill to receive emotional care and support commonly associated with the role of “patient.”

A

Factitious disorder

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18
Q

what can factitious disorder also be identified as

A

Munchausen syndrome.

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19
Q

The disorder may be imposed on another person under the care of the perpetrator
ie/ make child ill for attention

A

factious disorder by proxy

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20
Q

A client, experiencing lower extremity paralysis, is admitted to a medical unit. Extensive tests confirm disability but rule out any underlying organic pathology. The nurse concludes that this is most suggestive of which disorder?

A

conversion disorder

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21
Q

biochemical factors associated with somatic disorders

A

Decreased levels of serotonin and endorphins

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22
Q

This theory suggests that illness associated with anxiety disorder is an ego defense mechanism. Physical complaints are the expression of low self-esteem and feelings of worthlessness.

A

psychodynamic theory

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23
Q

what are the steps of learning theory r/t somatic disorders

A

primary, secondary, and tertiary gain

24
Q

May avoid stressful obligations or be excused from unwanted duties
ie/ call in sick to work

A

primary gain

25
Q

May become the prominent focus of attention because of the illness

A

secondary gain

26
Q

May relieve conflict within the family as concern is shifted to the ill person and away from the real issue

A

tertiary gain

27
Q

Past experience with serious or life-threatening physical illness, either personal or that of close relatives, can predispose the person to

A

illness anxiety disorder (learning theory)

28
Q

an inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness, and which is not due to the direct effects of substance use or a neurological or other medical condition

A

dissociative amnesia

29
Q

onset of dissociative amnesia usually follows what

A

severe psychosocial stress

30
Q

The inability to recall ALL incidents associated with the traumatic event for a specific period following the event

A

localized amnesia

31
Q

The inability to recall only CERTAIN incidents associated with a traumatic event for a specific period following the event

A

selective amnesia

32
Q

The inability to recall anything that has happened during the individual’s ENTIRE LIFETIME, including personal identity

A

generalized amnesia

33
Q

subtype of amnesia

there is a sudden, unexpected travel away from home with the inability to recall some or all of one’s past

A

dissociative fuge

34
Q

Characterized by the existence of two or more personalities within a single individual
Transition from one personality to another usually sudden, often dramatic, and usually precipitated by stress

A

dissociative identity disorder

35
Q

Characterized by a temporary change in the quality of self-awareness, which often takes the form of
Feelings of unreality
Changes in body image
Feelings of detachment from the environment
A sense of observing oneself from outside the body

A

Depersonalization-derealization disorder

36
Q

defined as a disturbance in the perception of oneself.

A

depersonalization

37
Q

described as an alteration in the perception of the external environment

A

derealization

38
Q

Symptoms of this depersonalization derealization are often accompanied by

A 
Anxiety and depression
Fear of going insane 
Obsessive thoughts 
Somatic complaints
Disturbance in the subjective sense of time
39
Q

Freud described dissociation as repression of distressing mental contents from conscious awareness.
Current psychodynamic explanations reflect Freud’s concepts that dissociative behaviors are a defense against unresolved painful issues.

A

psychodynamic theory

40
Q

DID is thought to serve as

A

a survival strategy for the child in this traumatic environment. (protective mechanism)

41
Q

According to psychodynamic theory, which primary defense mechanism would the nurse expect to find in a client with dissociative amnesia?

A

supression

42
Q

nursing diagnoses for somatic syndrome disorder

A

Ineffective coping evidenced by numerous physical complaints
Deficient knowledge [psychological causes for physical symptoms]
Chronic pain

43
Q

nursing diagnosis for illness anxiety disorder

A

Fear [of having a serious disease]

44
Q

nursing diagnoses for conversion disorder

A

Disturbed sensory perception (conversion disorder)

Self-care deficit

45
Q

nursing diagnoses for DID

A

Risk for suicide

Disturbed personal identity

46
Q

nursing diagnoses for dissociative amnesia

A

Impaired memory

Powerlessness

47
Q

client outcomes for somatic syndrome disorder

A

Copes effectively without resorting to physical symptoms
Verbalizes relief from pain
Has decreased frequency of physical complaints and interprets bodily sensations rationally
Is free of physical disability

48
Q

client outcomes for dissociative disorders

A

Can recall events associated with stressful situation
Can recall all events of past life
Can verbalize anxiety that precipitated the dissociation
Can demonstrate coping methods to avert dissociative behaviors
Verbalizes existence of multiple personalities

49
Q

implementation for somatic syndrome disorder

A

aimed at relief of discomfort from the physical symptoms.
Assistance is provided to the client in an effort to determine strategies for coping with stress by means other than preoccupation with physical symptoms.

50
Q

implementation for dissociative disorders

A

aimed at restoring normal thought processes.
Assistance is provided to the client in an effort to determine strategies for coping with stress by means other than dissociation from the environment

51
Q

When working with a client diagnosed with a somatic symptom disorder, which is the most appropriate nursing action?

A

Gradually minimize time focusing on physical symptoms.

52
Q

medical treatment modalities for dissociative disorders

A 
Individual psychotherapy
Hypnosis
Supportive care
Cognitive therapy
Group therapy
Integration therapy (DID)
Psychopharmacology
53
Q

what is the goal of pt with DID

A

merge personalities

54
Q

what is integration therapy used for

A

DID

it is the blending of all the personalities into one

55
Q

what medication is used for somatization disorders

A

none, is not usually effective

Psych Nursing (21 decks)

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