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NRSG 126: Mental Health > [Exam 3] Chapter 21 - Somatic Symptom Illnesses > Flashcards

[Exam 3] Chapter 21 - Somatic Symptom Illnesses Flashcards

1
Q

What does psychosomatic mean?

A

Used to convey the connection between the mind (psyche) and the body (soma) in states of health and illness. Essentially, mind can cause body to create physical symptoms

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2
Q

Examples of real symptoms that can begin/worsen because of emotional factors?

A

Diabetes, hypertension, and colitis

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3
Q

What does hysteria mean?

A

Multiple physical complaints with no organic basis; complaints are usually dramatic

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4
Q

Sigmund Freud observed that people with hysteria improved with what?

A

Hyponosis and experienced relief from their physical symptoms when they recalled memories and expressed emotions

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5
Q

Freud developed somatization, which is what?

A

That people can convert unexpressed emotions into physical symptoms

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6
Q

Definition of Somatization?

A

TRansference of mental experiences and states into bodily symptoms.

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7
Q

What can somatic symptom illnesses be categorized as?

A

presence of physical symptoms that suggest a medical condition without a demonstrable organic basis

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8
Q

Overview of Somatic Symptom Illness: What are the three central features of this?

A

Physical commplains suggest major medical illness but have no organic basis

Psychological factors and conflicts seem important in initiating, excarbating and maintaing symtoms

Symptoms or magnified health concerns not under clients conscious control

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9
Q

Overview of Somatic Symptom Illness: How do patients feel about their illness?

A

They are convienced that have serious physical problems despite negative test results

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10
Q

Overview of Somatic Symptom Illness: What is Somatic Symptom Disorder?

A

One or more physical symptoms that have no organic basis. Individual spends a lot of energy focused on health concerns, believe symptoms indicate serious illness, and experience anxiety

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11
Q

Overview of Somatic Symptom Illness: What is Conversion Disorder?

A

Unexplained, usually sudden deficits in sensory/motor (sudden blindness).

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12
Q

Overview of Somatic Symptom Illness: What does Conversion Disorder suually suggest?

A

A neurologic disorder but associated with psycholigcla factors. Significant functional impairment. May have la belle indifference about functional loss

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13
Q

Overview of Somatic Symptom Illness: In conversion disorder, what is la belle indifference?

A

A seeming lack of concern or distress

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14
Q

Overview of Somatic Symptom Illness: What is Pain disorder?

A

Primary physical symptom of pain, thats unrelieved by analgesics and affected by onset, severity, exacerbation, and maintenance

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15
Q

Overview of Somatic Symptom Illness: What is illness anxiety disorder (formerly hypochondriasis)

A

Preoccupation with fear that one has a serious disease (disease conviction)or one will get this (disease phobia).

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16
Q

Overview of Somatic Symptom Illness: More common in who?

A

Women, and represenet 5-7% of population.

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17
Q

Somatic Symptom Onset/Clinical: When does this appear?

A

Symptoms in adolescence, but may not diagnose until early adulthood (25 yeaars)

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18
Q

Somatic Symptom Onset/Clinical: When does conversion disorder occur?

A

BEtween ages 10-35 years

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19
Q

Somatic Symptom Onset/Clinical: When does pain disorder and illness anxiety disorder occur?

A

At any age

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20
Q

Somatic Symptom Onset/Clinical: When do those with somatic symptom illness and conversion disorder seek help?

A

After they’ve exhausted efforts at finding a diagnosed medical condition

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21
Q

Somatic Symptom Onset/Clinical: Those with illness anxiety or pain disorder and their chances of receiving tx?

A

Unlikely to receive treatment in mental health setting unless they have a comorbid condition

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22
Q

Somatic Symptom Illness and Related Disorders: What are fabricated or induced illness?

A

They are malingering and factitious disorders in which people feign or intentionally produce symptoms for some purpose or gain . They willfully control symptoms

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23
Q

Somatic Symptom Illness and Related Disorders: What is Malingering?

A

Intentional production of false or grossly exaggerated physical or psychological symptoms (To avoid work, evade crime, or obtain financial compensation).

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24
Q

Somatic Symptom Illness and Related Disorders: Symptoms in malingering?

A

Have no real physical symptoms or grossly exaggerate relatively mintor symptoms

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25
Q

Somatic Symptom Illness and Related Disorders: Why do people malinger?

A

External incentive or outcome that they view as important. They can stop physical symptoms as soon as they gained what they wanted

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26
Q

Somatic Symptom Illness and Related Disorders: What is factitious disorder, imposed on self?

A

Occurs when a person intentionally produces or feigns physical or psychological symptoms solely to gain attention . May inflect injury on themselves.

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27
Q

Somatic Symptom Illness and Related Disorders: What is factitious disorder, imposed on self known as?

A

Muchausen Syndrome

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28
Q

Somatic Symptom Illness and Related Disorders: What is Factitious disorder, imposed on others?

A

Mychausen Syndrome by Proxy

Occurs when person inflects illness or injury on someone else to gain the attention of emergency medical personnel or to be hero for saving the victim

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29
Q

Somatic Symptom Illness and Related Disorders: Example of Mychausen Syndrome by proxy?

A

Nurse gives excess IV potassium to client then “Saves his life” by perform CPR.

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30
Q

Somatic Symptom Illness and Related Disorders: Who is most likely to get factitious disorders?

A

People who are in or familiar with medical professions.

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31
Q

Somatic Symptom Illness and Related Disorders: What do medically unexplained symptoms (MUS) and functional somatic syndromes refer to?

A

Physical symptoms and limitations of function that has no medical diagnoses to explain their existence.

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32
Q

Somatic Symptom Illness and Related Disorders: Why is MUS more often acceptablefor the patient?

A

because it doens’t have the connotation of “it’s all in your head”.

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33
Q

Somatic Symptom Illness and Related Disorders: Effective treatmetn from patients perspective include what?

A

being listened to and heard regarding symptoms, learning to cope with symptoms and limitations, and learning to ignore some symptoms when possible.

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34
Q

Etiology and Psychosocial Theories: What do these theorists believe?

A

Believe people with soamtic symptom illnesses keep stress, anxiety, or frustration inside rather than expressing outwardly (internalization) . Express feelings through physical symptoms

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35
Q

Etiology and Psychosocial Theories: Some people exerience alexithymia, which is what?

A

the inability to identify emotions . Have difficulty dealing with interpersonal conflict

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36
Q

Etiology and Psychosocial Theories: Worsening of physical symptoms helpspeople meet what?

A

Psychological needs for security, attention, and affection through primary adn secondary gain

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37
Q

Etiology and Psychosocial Theories: What are primary gains?

A

Direct internal benefits that being sick provides, such as relief of anxiety, conflict, or distress

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38
Q

Etiology and Psychosocial Theories: What are secondary gains?

A

external or personal benefits received from others because one is sick, such as attention from family members and comfort measures

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39
Q

Etiology and Biologic Theories: How may clients handle stimuli here?

A

They experience normal body sesnation sucha s peristalsis and attach a pathologic rather than normal meaning to it

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40
Q

Etiology and Biologic Theories: Example of having too little inhibition of sensory input?

A

It amplifies awareness of physical symptoms.

Minor discomfort such as muscle tightness becomes amplified because of clients concerns and attention to tightness

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41
Q

Etiology and Biologic Theories: Research has shown that visceral hypersensitivity is associated with what?

A

severity of GI symptoms in large cohorts of patients with functional GI disorders

42
Q

Etiology and Cultural Considerations: Pseudoneurologic symptoms of somatization disorder in africa and south asia include what?

A

Burning hands and feet and nondelusional sensation of worms n heat or ants under skin

43
Q

Etiology and Cultural Considerations: Men of india often have dhat, which is what?

A

Hypochondriacal concerns about loss of semen.

44
Q

Etiology and Cultural Considerations: What is koro?

A

Southeast Asia, belief that penis is shrinking and will disappear into the abdomen.

45
Q

Etiology and Cultural Considerations: What are falling out episodes?

A

South US and Carribean Islands

Characterized by a sudden collapse during which person cannot see or move

46
Q

Etiology and Cultural Considerations: What is Hwa-Byung?

A

Korean.

Attributed to suppression of anger and includes insomnia, fatigue, panic, indigestion

47
Q

Etiology and Cultural Considerations: What is sangue dormido?

A

(Sleeping blood) Portugese who report pain, numbness, tremors, paralysis, seziures, blindess

48
Q

Etiology and Cultural Considerations: What is Shenjing Shuairuo?

A

Occurs in China. Includes physical and mental fatigue, dizziness, headache, pain, sleep disturbance

49
Q

Somatic Symptom Illness and Treatment: Treatment focuses on what?

A

Managing symptoms and improving quality of life

50
Q

Somatic Symptom Illness and Treatment: What must providers how patient?

A

Empathy and sensitivity to clients physical complients. Trusting relationship helps ensure clients.

51
Q

Somatic Symptom Illness and Treatment: What other mental illness may accompany somatic symptom illnesses?

A

DEpression, anxiety

52
Q

Somatic Symptom Illness and Treatment: Treatment for this?

A

Antidepressants, such as SSRI

53
Q

Somatic Symptom Illness and Treatment: What common SSRIs are used?

A

Fluxetine (Prozac)

Paroxetine (Paxil)

Sertraline (Zoloft)0

54
Q

Somatic Symptom Illness and Treatment: Fluoxetine (Prozac) daily dosage?

A

20-60 mg/day

55
Q

Somatic Symptom Illness and Treatment: Fluoxetine (Prozac) nursing considerations?

A

Monitor for rash, hives, insomnia, headache, anxiety, drowsiness, loss of appetitie, avoid alcohol

56
Q

Somatic Symptom Illness and Treatment: Paroxetine (Paxil) dose?

A

20-60 mg/day

57
Q

Somatic Symptom Illness and Treatment: Paroxetine (Paxil) nursing considerations

A

loss of appetite, dizziness, dry mouth, insomnia, sweating, sexual dysfunction, avoid alcohol

58
Q

Somatic Symptom Illness and Treatment: Sertraline (Zoloft) dose?

A

50-200 mg/day

59
Q

Somatic Symptom Illness and Treatment: Sertraline (Zoloft) nursing considerations?

A

Loss of appetite, diarrhea, headache, insomnia, sexual dysfunction, avoid alcohol

60
Q

Somatic Symptom Illness and Treatment: What may be useful for clients with pain disorder?

A

Referral to chronic pain clinic.

PT can help maintain and build muscle tone.

Avoid administering narcotic analgesics to these clients bc of risk for dependence

61
Q

Somatic Symptom Illness and Treatment: What do clients with pain disorder learn in chronic pain clinic?

A

Pain management, such as visual imaging and relaxation.

62
Q

Somatic Symptom Illness and Treatment: What therapy may someone do?

A

Therapy groups, or structured cognitive-behavioral group shows improved physical and emotional health.

63
Q

Somatic Symptom Illness and Treatment: Overall goals of therapy groups?

A

offering peer support, sharing methods of coping, and perceiving and expressing emotion.

64
Q

Somatic Symptom Illness and Assessment: What is done here?

A

Nurse must investigate physical healths tatus thoroughly to ensure there is no underlying pathology

65
Q

Somatic Symptom Illness - Assessment & History: What will patients most likely provide?

A

Lengthy and detailed account of previous physical problems, numerous diagnsotic tests and multipl eproviders.

66
Q

Somatic Symptom Illness - Assessment & History: Why may they be angry at you?

A

Because the medical community cannot figure out what’s wrong with them.

67
Q

Somatic Symptom Illness - Assessment & History: How will patient with conversion disorder act?

A

Show little emotion when describing physicial limitations or lack of a medical diagnosis .

68
Q

Somatic Symptom Illness - Assessment & Appearance/Motor: How to they appear?

A

Walk slowly with unusual gait because of pain. Exhibit facial expression of discomfort.

69
Q

Somatic Symptom Illness - Assessment & Appearance/Motor: How do patients with domatization disorder describe their complaints?

A

in colorful, exaggerated terms, but often lack specific information

70
Q

Somatic Symptom Illness - Assessment & Mood/Affect: How is moodo?

A

Labile, shifting from seeming depressed and sad when describing physical problems to excited when talking about how they went to the hospital in middle of night by ambulance

71
Q

Somatic Symptom Illness - Assessment & Mood/Affect: How are emotions?

A

Often exaggerated as are physical symptoms.

72
Q

Somatic Symptom Illness - Assessment & Thought Content/Process: Content of thinking is primarily about

A

often exaggerated physical concerns. Think simple cold is pneumonia.

73
Q

Somatic Symptom Illness - Assessment & Thought Content/Process: Clients with illness anxiety disorder focus on what?

A

Fear of serious illness rather than the existence of illness, as seen with clients with somatoform disorders . Preoccupied with physical concerns .

74
Q

Somatic Symptom Illness - Assessment & Thought Content/Process: Patients with hypochondriasis are preoccupied with ?

A

bodily functions, ruminate about illness, and are fascinated with medical information and have unrealistic fears about potential infection

75
Q

Somatic Symptom Illness - Assessment & Sensorium/Intellectual: How are they here?

A

Alert and oriented. Intellectual functions unimpaired

76
Q

Somatic Symptom Illness - Assessment & Judgement/Insight: Insihgt about their behavior?

A

Little or no insight. Firmly convinced their problem is intirely physical and often believe others don’t understand

77
Q

Somatic Symptom Illness - Assessment & Self-Concept: Focus on what?

A

Only physical part. Unlikely to think about personal characteristics or strengths and are uncomfortable when asked to do so. Lack confidence, have little success in work siutations, and have difficulty managing daily life issues.

78
Q

Somatic Symptom Illness - Assessment & Roles/Relationshps: How do they do in thier job?

A

Often unemployed because excessive absenteeism or inability to perform work. May quit voluntarily as well.

79
Q

Somatic Symptom Illness - Assessment & Roles/Relationshps: How are the relationships here?

A

Family roles hard. May decline to go out becase fear of being ill.

80
Q

Somatic Symptom Illness - Assessment & Physiological and Self-Care Concerns: What problems do they often have?

A

sleep pattern disturbances, lack basic nutrition, and get no exercise.

81
Q

Somatic Symptom Illness - Intervention and Providing Health Teaching: What must nurse help client learn?

A

How to establish daily routine that includes improved health behaviors.

82
Q

Somatic Symptom Illness - Intervention and Providing Health Teaching: What other areas may client need help in?

A

adequate nutritional intake, improved sleep patterns, and realistic balance of activity and rest.

83
Q

Somatic Symptom Illness - Intervention and Providing Health Teaching: How does a nurse help validate client’s feelings?

A

Let’s take a walk outside for some fresh air

I wish I could but I feel so terrible

I know this is difficult, but some exercise is essential

84
Q

Somatic Symptom Illness - Intervention and Providing Health Teaching: Nurse can explain that inactivity and poor eating habits perpetuate what?

A

Discomfort and that it is often necessary to engage in behaviors even when one doesn’t feel like it

85
Q

Somatic Symptom Illness - Intervention and Providing Health Teaching: How can nurse promote eating?

A

“I promise I’ll eat just as soon as I’m hungry”

“Actually, if you begin to eat a few bites , you’ll begin to feel better, and your appetite may improve”

86
Q

Somatic Symptom Illness - Intervention and Providing Health Teaching: How should nurse confront clients about somatic symptoms?

A

Do not attempt to confront clients about them and do not tell them that symptoms are not “real”..

87
Q

Somatic Symptom Illness - Intervention and assisting client in expressing emotion: How to help client see mind-body relationship?

A

Teaching about the relationship between stress and physical symptoms . May use detailed journal of their symtpoms.

88
Q

Somatic Symptom Illness - Intervention and assisting client in expressing emotion: Why is a journal useful?

A

May help clients see when physical symptoms seemed worse or better and what other factors may have affected that perception.

89
Q

Somatic Symptom Illness - Intervention and assisting client in expressing emotion: How does nurse teach family about primary and secondary gains?

A

If family provides attention to client when they are feeling beter, clients are more likely to continue doing so.

90
Q

Somatic Symptom Illness - Intervention and teaching coping strategies: What two categories of coping are important to learn?

A

Emotion-focused coping strategies (help client relax and reduce feeling of stress)

Problem-focused coping strategies (help resolve or change client’s behavior or siutation)

91
Q

Somatic Symptom Illness - Intervention and teaching coping strategies: What are some emotion-focused strategies?

A

Include progessive relaxation, deep breathing, guided imagery and distractions such as music.

92
Q

Somatic Symptom Illness - Intervention and teaching coping strategies: examples of problem-focused coping strategies?

A

problem-solving methods, applying the process to identified problems, and role-playing interactions with others.

93
Q

Somatic Symptom Illness - Intervention and teaching coping strategies: Example of this?

A

client may complain that no one comes to visit. Nurse can help client plan social contact with others.

94
Q

Somatic Symptom Illness - Evaluation: How to tell if treatment work?

A

Client will make fewer visits to physicians, less medications, and more positive coping techniques.

95
Q

Mental Health Promotion: What is cyberchondria?

A

Refers to excessive or repeated online searches for health-related information that is distressing or anxiety provoking for the person

96
Q

Somatic symptom illnesses include what?

A

somatic symptom disorder, conversion disorder, illness anxiety disorder, and pain disorder

97
Q

What are internalization and somatization?

A

Chief defense mechanisms seen in clients with somatoform disorders

98
Q

CLients who cope with stress thorugh somatizing handle this how?

A

unable to cope to identify emotional feelings and interpersonal issues and have few coping abilitiets unrelated to physical symptoms.

99
Q

Nursing interventions that may be effective for clients who somatize involve what?

A

providing helth teaching, identifying emotional feelings and stress, and using alternative coping strategies

100
Q

How quikcly does somatic symptom illnesses heal?

A

Chronic or recurrent so progress toward treatment can be slow and difficult

NRSG 126: Mental Health (24 decks)

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