Exam 4 Flashcards

1
Q

Somatic Symptom Disorders

A

SSD, Illness Anxiety Disorder, Conversion Disorder, Psychological Factors Affecting Medical Conditions, Factitious Disorder

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2
Q

Somatization

A

Expression of stress through physical symptoms that are often manifestations of psychological and emotional distress

Symptoms expressed in place of anxiety, depression, or irritability

Holistic Approach

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3
Q

Somatic Symptom Disorder

A

One or more distressing symptoms

Excessive thoughts, anxiety, and behaviors around symptoms, or health concerns

Without significant physical findings and medical diagnosis

Suffering is authentic

High level of functional impairment

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4
Q

Illness Anxiety Disorder

A

Misinterpretation of physical sensations

Preoccupation with having or acquiring serious illness for at least 6 months

High anxiety about health

Excessive health-related behaviors or maladaptive avoidance

May be care-seeking or care-avoidant

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5
Q

Conversion Disorder

A

Neurological symptoms in the absence of a neurological diagnosis

Presence of deficits in voluntary motor or sensory functions

Common symptoms: paralysis, blindness, movement and gait disorders, numbness, paresthesias, loss of vision or hearing, or episodes resembling epilepsy

“La belle indifference” versus distress

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6
Q

Psychological Factors Affecting Medical Condition

A

Psychological factors that increase risk for medical diseases, magnify them, or interfere with their treatment

Depression, CV diseases, cancer

Stress

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7
Q

Assessment of Somatic Symptom Disordes

A
Psychosocial factors
Coping skills
Spirituality and religion
Secondary gains
Cognitive style
Ability to communicate feelings and emotional needs
Dependence on medication
Self-assessment
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8
Q

Nursing Diagnoses for Somatic Symptom Disorders

A
Ineffective coping
Anxiety
Risk for loneliness
Powerlessness, hopelessness
Social isolation
Pain
Altered family processes
Risk for suicide
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9
Q

Outcomes Identification for Somatic Symptom Disorders

A

Shared decision making
Patient participation
Outcome criteria realistic and attainable
Small steps or increments

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10
Q

Factitious Disorder

A

Artificially, deliberately, and dramatically fabricate symptoms or self-inflict injury

Goal of assuming sick role

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11
Q

Types of Factitious Disorders

A

Factitious disorder imposed on self

Factitious disorder imposed on another

Malingering

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12
Q

Malingering

A

Condition related to factitious disorder

Conscious fabrication of illness or exaggerating symptoms for secondary gain such as insurance fraud, prescription medication, avoidance of prison or military service

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13
Q

Etiology of Eating Disorders

A

Genetics, neurobiological

Psychological factors

Environmental factors

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14
Q

Assessment of Anorexia Nervosa

A

Perception of the problem, eating habits, history of dieting, methods used to achieve weight control, value attached to a specific shape and weight, interpersonal and social functioning, mental status and psychological parameters

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15
Q

Anorexia Nervosa Interventions

A
Suicidal ideation first
Psychosocial interventions
Pharmacological interventions
Integrative medicine
Health teaching and health promotion
Safety and teamwork
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16
Q

Assessment of Bulimia Nervosa

A

Appear well: at or near ideal body weight

Physical signs: enlarged parotid glands, dental erosion, caries

Emotional signs: impulsivity and compulsivity, non-nurturing family relationships, familial/social instability, difficult interpersonal relationships

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17
Q

Bulimia Nervosa Interventions

A
Teamwork and safety
Pharmacological interventions
Counseling
Health teaching and health promotion
Psychotherapy
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18
Q

Binge Eating Interventions

A
Psychosocial interventions
Pharmacological interventions
Surgical interventions: bariatric surgery
Health teaching and health promotion
Teamwork and safety
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19
Q

Feeding Disorders

A

Pica

Rumination

Avoidant/Restrictive Food Intake

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20
Q

Pica

A

Eating nonfood items well past toddlerhood

Not part of other illness

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21
Q

Rumination

A

Regurgitation with rechewing, reswallowing, or spitting

No medical or mental reason

22
Q

Avoidant/Restrictive Food Intake

A

Starts in childhood

Note: 40% of “picky” eaters resolve on their own

Low BMI

No distorted body image

23
Q

Consequence of Sleep Loss

A
Excessive sleepiness
Sleep deprivation
Mental and physical problems
Psychomotor impairment
Increased risk for errors
24
Q

Non-REM Sleep

A

Stage 1: transition between awake and sleep

Stage 2: deeper; occupies 45-55% of total sleep time; reduced HR and respiration

Stage 3: slow wave deep or delta sleep, further reduction in HR, respiratory rate, BP, and response to external stimuli. Restorative sleep

25
Q

REM Sleep

A

Reduction and absence of skeletal muscle tone

Bursts of rapid eye movement

Myoclonic twitches of facial and limb muscles

Dreaming

Autonomic nervous system variability

Atonia

26
Q

Regulation of Sleep

A

Complex interaction between homeostatic process (sleep drive) which promotes sleep, and circadian process (circadian drive) which promotes wakefulness

27
Q

Sleep Latency

A

The time it takes to fall asleep

28
Q

Sleep Architecture

A

Structural organization of NREM and REM sleep

29
Q

Hypnogram

A

Graphic display of sleep architecture

30
Q

Sleep Continuity

A

Distribution of sleep and wakefulness across the sleep period

31
Q

Sleep Fragmentation

A

Disruption of sleep stages

32
Q

Sleep Efficiency

A

Ratio of sleep duration to time spent in bed

33
Q

Sleep Drive

A

Homeostatic process that promotes sleep

34
Q

Circadian Drive

A

Process that promotes wakefulness

35
Q

Zeitgebers

A

Exogenous factors that help set our eternal clock to a 24-hour cycle

36
Q

Master Biological Clock

A

SC nucleus in the hypothalamus that regulates a host of functions

37
Q

Basal Sleep Requirement

A

Amount of sleep necessary to feel fully awake and sustain normal levels of performance

38
Q

Sleep Requirements

A

Varies from individual to individual

Most adults require 7-8 hours of sleep

Long sleepers require more than 10 hours of sleep each night

Short sleepers can function effectively on fewer than 5 hours of sleep per night

39
Q

Sleep Disorders

A
Hypersomnia disorders
Narcolepsy/hypocretin deficiency
Breathing-related sleep disorders
Circadian rhythm disorders
Disorders of arousal
Nightmare disorder
REM sleep behavior disorder
Restless legs syndrome
Substance-induced sleep disorders
Insomnia
40
Q

Diagnostic Tests for Sleep Disorders

A

Polysomnography

Multiple Sleep Latency Test

Maintenance of Wakefulness Test

Actigraphy

41
Q

Polysomnography

A

All-night test using electrodes to diagnose sleep-related disorders and nocturnal seizure disorders

42
Q

Multiple Sleep Latency Test

A

Daytime nap that measures sleepiness in a sleep-conducive setting

43
Q

Maintenance of Wakefulness Test

A

Evaluates ability to stay awake in a situation conducive to sleep

44
Q

Actigraphy

A

Uses a tracker to record body movement over a period of time to detect sleep patterns

45
Q

Insomnia Disorder

A

Difficulty with sleep initiation

Sleep maintenance

Early awakening

Nonrefreshing, nonrestorative sleep

Symptoms 3 times a week for at least 3 months

46
Q

3P Model of Insomnia

A

Assesses causes, suggests interventions, and provides treatment rationales

Predisposing factors
Precipitating factors
Perpetuating factors

47
Q

Hypersomnolence Disorders

A

Excessive daytime sleepiness

Chronic–begins in young adulthood

Excessive sleepiness impairs social and vocational functioning

Treatment: maintains regular sleep-wake schedules, pharmacotherapy

48
Q

Narcolepsy

A

Uncontrollable need to sleep

Symptoms: irresistible attacks of refreshing sleep, cataplexy, sleep paralysis, and hypnagogic hallucinations

Do not feel rested regardless of amount of sleep

Diagnosis: measuring hypocretin levels

Treatment: lifestyle modifications and long-acting stimulant medication

49
Q

Obstructive Sleep Apnea Hypopnea Syndrome

A

Repeated episodes of upper airway collapse and obstruction

Results in sleep fragmentation

Cannot breathe and sleep at the same time

Diagnosis: clinical evaluation and polysomnography

Treatment: CPAP therapy

50
Q

Central Sleep Apnea

A

Cessation of breathing during sleep

Instability of respiratory control system

Related to aging, advanced cardiac or pulmonary disease, neurological disorders

51
Q

Sleep-Related Hypoventilation

A

Sustained oxygen desaturation in sleep

No apnea or respiratory events

Associated with morbid obesity, lung parenchymal disease, or pulmonary vascular pathology