Somatic Symptom Disorders

Which statement made by a client would support the diagnosis of Illness anxiety disorder?

"I know I have cancer, but the doctors just cannot find it." Previously known as hypochondriasis, illness anxiety disorder results in the misinterpretation of physical sensations as evidence of a serious illness. People experience extreme worry and fear about the possibility of having a disease.

what are some outcomes ?

effective coping, support systems, pain control, positive self regard.

Malingering

fabrication of disorder to get a secondary gain like disability, evading military service, receiving a reduced prison sentence.

Whats a munchausen by proxy

harming others typically their child or elder client to get attention.

Which nursing diagnosis should be investigated for clients with somatoform disorders?

ineffective coping

Conversion disorder

neuro symptoms w/o cause--> paralysis, loss of vision, numbness. Either dramatic or indifferent. emotional stress will cause a physical condition and worsen immunity.

illness anxiety disorder

no somatic or mild. extreme worry/fear. trigger by exposure to disaster.

How can you assess secondary gains

"What are you unable to do now that you used to be able to do?" "How has this problem affected your life?"

A 23 years old is admitted with reports of abdominal pain, dizziness, and headache. When told that all the results of a physical workup have been negative, the client shares, "Now I am having back pain." Which notation in the client's medical record may alert the nurse to the possibility of malingering?

A court date this week for drunk driving. Malingering is a process of fabricating an illness or exaggerating symptoms to gain a desired benefit or avoid something undesired, such as to obtain prescription medications, evade military service, or evade legal action. It is more common in men, those who have been neglected or abused in childhood, and those who have had frequent childhood hospitalizations. Adoption is not known to be a causative factor in malingering.

Secondary gains

Benefits of being treated for illness, including the ability to rest, to be freed from unpleasant tasks, and to be taken care of by others.

Based on current knowledge, what form of therapy is most appropriate for a client diagnosed with a conversion disorder?

CBT

What would be an appropriate expected outcome of the treatment plan for a client diagnosed with a conversion disorder that interferes with the ability to walk effective?

Client will be able to state two new effective coping skills within 2 weeks. An appropriate outcome for somatization disorders is to be aware of negative coping strategies and learn new, effective skills for coping within a realistic timeframe.

Whats the basic thing the nurse can do?

Help patient work through their needs

What statement by a client would indicate that goals for treatment for a somatization disorder are being achieved?

I don't think about my symptoms all the time as I used to." such as GAD

A woman suddenly finds she cannot see but seems unconcerned about her symptom and tells her husband, "Don't worry, dear. Things will all work out." Her attitude is an example of what process?

La belle indifference is an attitude of unconcern about a symptom that is unconsciously used to lower anxiety.

Whats significance of case management role?

Limit healthcare costs with doctor shopping. -also positice

Whats the name of the factitious disorder

Munchausen syndrome

How do somatic symptom disorder pts present?

Pain, fatigue, headache, dizziness, swelling, SOB, numbness, abd pain. Lots of fear, excessive concern.

A class of medications commonly prescribed for somatic disorders is

anxiolytics

What are risks with this patient

pain..substance abuse disorder.

What is Munchausen syndrome?

self-induced illness. purpose for attention/excitement. will jump dr to dr. Angry if limited to rules. Possible personality disorder. -comorbidities: antisocial, narcissistic.

Etiology of these disorders

sensitive to negativity, less resilient, prone to neg interpretations of life events. genetic. psych theories: protective defense from abuse or low self esteem; cry for attention; manipulation technique.

illness anxiety disorder results in...

the misinterpretation of physical sensations as evidence of a serious illness