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Somatoform and Related DisordersPsychiatric Nursing: Contemporary Practice

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What problems in physical functioning are often experienced by patients with somatization disorders?
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Problems with sleep, fatigue, activity, sexual functioning, and overwhelming lack of energy.
Why is a pharmacologic assessment especially important for patients with somatization disorders?
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They tend to see several health providers and take large numbers of drugs. In addition, they tend to have unusual side effects and increased sensitivity to medications.
In general, what nursing management strategies should be employed when treating patients with somatization disorders?
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Focus on overcoming symptoms, not the 'illness,' avoid aggressive pharmacologic treatments, respect reports of physical complaints with each visit and address the source of pain using nonpharmacologic interventions.
When is pharmacologic management of somatization disorders indicated?
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If a depressed mood persists and insomnia, decreased appetite, decreased libido, and anhedonia are present.
What medications have been shown to help people with somatization disorders manage pain and depression?
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Venlafaxine/Effexor and duloxetine/Cymbalta (SNRIs)
Once a patient with somatization disorders has been prescribed medications for treating anxiety and/or depression, when should the medication be discontinued?
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Once the symptoms have been in remission for at least a year
What medication has been effective in treating depression, headaches and chronic pain in people with somatization disorders?
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The MAOI phenelzine/Nardil (there's many risks and contraindications like no OTC meds or tyramine containing foods)
In order to assess the effectiveness of medications prescribed to patients with somatization disorders, they should give them at least ________ weeks to determine their response.
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6 weeks
When are common times for a person with a somatization disorder to develop symptoms?
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During times of emotional stress, and on anniversaries of losses or trauma
What is the most important ongoing intervention for patients with somatization disorders?
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Maintenance of a therapeutic relationship, which requires time and patience
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On what basis are treatment outcomes evaluated for patients with somatization disorders?
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Gradually increased social contact, gradual reduction in the number and contacts with HCP, improved ability to cope.
What are the recommendations for treating a patient with a somatization disorder in an inpatient setting?
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The patient should be the responsibility of one nurse who provides or oversees all their nursing care (aiding in establishing a therapeutic relationship)
When discussing health promotion with a person who has a somatization disorder, it is best to do it within the context of?
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Prevention of future problems
What is the main difference between somatization disorder and undifferentiated somatoform disorder?
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The patients don't have multiple, unexplained physical problems prior to age 30, instead they may have just one.
What are the typical complaints of patients with somatoform disorder?
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Problems with fatigue, loss of appetite, GI or GU problems which lasts for at least 6 months.
_________ is a term used in other parts of the world to describe a syndrome of chronic fatigue and weaknesses (somatoform disorder in the US).
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Neurasthenia
__________ is a condition in which emotional distress or unconscious conflict are expressed through physical symptoms including impaired coordination/balance, paralysis, aphonia, difficulty swallowing, lump in the throat, urinary retention, loss of touch, vision, deafness, hallucinations or seizures.
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Conversion disorder
What are the pseudoneurologic symptoms commonly manifested in conversion disorders?
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Impaired balance/coordination, aphonia, paralysis, difficulty swallowing, or lump sensation in the throat.
How should a nurse approach a patient with conversion disorder?
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Treat the conversion symptom as real with the potential of having distressing psychological aspects. Acknowledge it and help the patient deal with it.
In pain disorder, what is the onset of pain often associated with?
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Psychological factors like a traumatic or humiliating experience
How do pain disorders typically manifest in women?
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Headaches and/or musculoskeletal pain that is severe enough to seek medical help and interferes with social or occupational functioning.
  
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