Somatoform Disorders, Cognitive Disorders and Anger & Aggression
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| When you think of somatoform, what should come to mind? | show 🗑
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| When you think of dissociative, what should come to mind? | show 🗑
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| show | Pt has a great deal of anxiety and no way of relieving it, so it’s repressed and manifests as physical ailment
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| show | Pain in regards to GI, sexual, neurological
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| show | Significant problems with pain that affect social, occupational and other areas of functioning
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| show | Stressful situations
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| What is the primary gain with pain d/o? | show 🗑
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| What is the secondary gain with pain d/o? | show 🗑
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| What is hypochondriasis? | show 🗑
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| What d/o usually accompany hypochondriasis? | show 🗑
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| show | A loss or change in body function where the client is unaware that it results from a psychological problem
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| show | Voluntary motor function such as paralysis, difficulty swallowing or sensory functioning
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| show | After extreme psychological stress
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| What is La Bell Indifference? | show 🗑
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| show | Yes, sometimes it can get better spontaneously but seizures and tremors may not be resolved
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| show | An exaggerated belief that the body is defective or deformed
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| What somatoform disorder is the most common? | show 🗑
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| What is body dysmorphic disorder commonly associated with? | show 🗑
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| What personality disorders are commonly associated with? | show 🗑
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| How do you treat body dysmorphic disorder? | show 🗑
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| show | Genetics-higher incidence of kids w/parents w/disorder; biochemical-low lvls of sero. & endo.; psychodynamic-ego DM & low self-esteem; family dynamics-limited expression of emotions/conflicts; learning theory-reinforced when pt avoids stressful situations
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| show | A rare pathologic loss of memory either organic, emotional, dissociative or mixed. May be permanent or limited
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| show | Important personal information
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| show | Localized amnesia, selective amnesia, continuous amnesia, generalized amnesia & systematized amnesia
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| What is dissociative fugue? | show 🗑
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| How are some of these clients with dissociative fugue found? | show 🗑
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| show | It could last hours to days and then may suddenly resolve on it’s own
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| How common is dissociative fugue? | show 🗑
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| What is dissociative identity disorder? | show 🗑
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| show | Usually suddenly, and the personalities have gaps of lost time where they can lose days, months and years
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| With DID, are the personalities aware of one another? | show 🗑
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| show | A common and temporary form of detachment from environment or seeing oneself from outside the body
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| show | Schizophrenia, depression to name a few
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| show | Derealization occurs with depersonalization disorder and is when a person’s perception of the environment is altered
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| How does a client feel when they are experiencing a depersonalization disorder? | show 🗑
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| What are some predisposing factors associated with dissociative disorders? | show 🗑
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| What are some nursing diagnoses for somatoform disorders? | show 🗑
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| show | It focuses on personal and social difficulties
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| How does group therapy help with somatoform disorders? | show 🗑
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| show | It works with the family and significant others who enable symptoms
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| What psychopharmacology works with somatoform disorders? | show 🗑
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| show | TCA- clomipramine (Anafranil) and (SSRI) fluoxetine (Prozac)
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| show | None, these therapies work best when they are combine with one another
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| show | Most of the time it will resolve spontaneously when stressful situation is removed, harder cases will used Barbiturate such as Amytal, hypnosis but the pt has to eventually remember the trauma to be able to work through it
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| show | The pt has to come to terms with the trauma with the use of cognitive/group therapy
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| show | By integration using psychotherapy and having the personalities remember with feeling the trauma; takes years of psychotherapy because sometimes the personalities don’t want to come together
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| How is depersonalization disorder treated? | show 🗑
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| What are examples of dementia? | show 🗑
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| Which two examples of dementia are very rare? | show 🗑
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| What is the percentage of pts with Parkinson’s Disease that will have dementia? | show 🗑
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| What is the definition of cognitive disorder? | show 🗑
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| show | It is a disturbance in cognition, confusion, excitement, disorientation and clouding of consciousness that includes hallucinations and illusions
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| Is Delirium the same as Dementia? | show 🗑
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| show | They may be very confused and become excited, if their routine becomes disrupted, they can become very agitated and have hallucinations and illusions
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| Is it with dementia or delirium that a pt can experience hallucinations and illusions? | show 🗑
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| What is the onset of delirium? | show 🗑
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| What are the etiologies of delirium? | show 🗑
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| show | It causes confusion and excitability and when weaned, most cognitive processes should come back; most cases are reversible
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| What is dementia? | show 🗑
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| What is primary dementia? | show 🗑
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| What is secondary dementia? | show 🗑
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| What is the progression of dementia? | show 🗑
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| What are the 7 stages of progression of dementia? | show 🗑
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| What happens in the first stage of dementia? | show 🗑
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| What happens in the second stage of dementia? | show 🗑
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| show | Interference starts to show up in relationships/job, pts will have less focus on tasks, they may remember deadline but they won’t get things done due to wandering mind & they can’t totally focus, other ppl pt knows start to see something is wrong
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| show | Pt begins to forget significant events in their life & ppl closest to them, evident confusion, work & social is hard, severe cognitive problems, confabulation, pt's aware they are sicker, may ask for help & begin to get depressed, seems easily lost
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| show | Pt is not able to perform their own ADL’s, very disorientated and start to withdraw
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| show | Pt cant name objects they’re using or it’s function, no longer remember the name of ppl close to them, incontinence, insomnia, sun downing, need full supervision
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| What happens in the seventh stage of dementia? | show 🗑
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| What is the progression of Alzheimer’s Disease? | show 🗑
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| show | Blood vessels are affected
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| What is vascular dementia? | show 🗑
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| What will happen to the areas of the brain that are affected by vascular dementia? | show 🗑
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| show | It has a more abrupt onset, they are small strokes that destroy parts of the brain; common signs are weakness of extremities, small steps and speech difficulty
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| show | The virus leads to brain infections and may also cause dementia during the end stage; pt can’t make reasonable judgments
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| show | They almost follow the same course as the other stages of dementia with discernible to confusion; behavioral changes and psychoses
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| What are other types of Dementia due to? | show 🗑
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| What is Lewy Body Disease? | show 🗑
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| show | The pt has trouble sleeping
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| What are early precursors for Lewy body disease? | show 🗑
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| What is Pick’s disease? | show 🗑
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| What is Creutzfeldt-Jakob disease? | show 🗑
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| What are examples of a general medical condition that can cause dementia? | show 🗑
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| show | The inability to remember/retain experiences from the past; inability to learn new information & recall previously learned information
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| How are amnesic disorders different from dementia? | show 🗑
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| Is there confabulation and denial involved with amnesic disorders like there are with dementia? | show 🗑
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| What are amnesic disorders due to? | show 🗑
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| How is the nursing process involved with amnesic disorders? | show 🗑
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| What are all the labs looked at for dementia? | show 🗑
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| What are some nursing diagnoses for dementia? | show 🗑
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| show | They become agitated and confused
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| What sort of environment should you have for a dementia pt? | show 🗑
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| How can you prevent sun downing with dementia patients? | show 🗑
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| What are the treatment modalities for delirium? | show 🗑
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| show | It causes the release of calcium to increase and disrupt and destroy neuron
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| What is the definition of anger? | show 🗑
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| What are the physiological changes with anger? | show 🗑
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| Is anger a normal state? | show 🗑
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| show | When the individual loses control of their anger
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| What is the definition of aggression? | show 🗑
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| Is aggression considered negative or positive? | show 🗑
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| What are some predisposing factors to anger and aggression? | show 🗑
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| What is operant conditioning? | show 🗑
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| show | Epilepsy, tumors in the brain, encephalitis; these pathways of normal behavior can be located in diseased area or infected area
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| show | Cushing’s disease hormonal changes, too little thyroid; PMS not correlated; Hypothesis that epi and norepi may be associated with high levels of violence and acting out but not sure
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| What are some socioeconomic factors that can predispose one to anger and aggression? | show 🗑
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| What are some environmental factors that can predispose one to anger and aggression? | show 🗑
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| What are 3 factors that lead to aggression? | show 🗑
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| What is the best intervention for anger and aggression? | show 🗑
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| What is uncontrolled anger called seen as? | show 🗑
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| show | Yes but it is usually viewed as negative, clients need assistance to understand that anger is an acceptable emotion
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| What is the cause of aggression? | show 🗑
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| show | Mild (sarcasm), moderate (slam doors), severe (threats of violence), extreme physical acts
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| Is aggression goal-directed? | show 🗑
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| What is intent? | show 🗑
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| show | Accidents, which are unintentional harm or destruction
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| show | Aggression is done to harm; doesn’t have to be physical only, can be verbal, mental, etc
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| How can you successfully manage aggression? | show 🗑
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| What are a couple of nursing diagnoses for aggression? | show 🗑
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| What are some important interventions for aggression? | show 🗑
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| How can you successfully manage aggression? | show 🗑
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| show | Ineffective coping and Risk for self-directed or other directed violence
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| What are some important interventions for aggression? | show 🗑
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