30 Questions
Which nursing diagnosis is associated with the presence of physical limitation or disability with indifference to the severity of the symptom?
Ineffective Denial
What is the expected outcome for the client in the immediate phase?
Identify the conflict underlying the physical symptoms within 4 to 5 days
What is a nursing intervention aimed at diminishing secondary gain in the client?
Involve the client in the usual activities, self-care, eating in the dining room, and so on, as you would other clients
What is the primary assessment data associated with the nursing diagnosis of Ineffective Denial?
Presence of physical limitation or disability with indifference to the severity of the symptom
What is the expected outcome for the client in the stabilization phase?
Verbalize feelings of fear, anger, guilt, or inadequacy
What is the immediate nursing intervention to enhance the client's participation and diminish secondary gain?
Involve the client in the usual activities, self-care, eating in the dining room, and so on, as you would other clients
What should be included in the initial nursing assessment?
Physical assessment, history of previous complaints, and consideration of each current complaint
When should the client be referred to medical staff for assessment and treatment?
For new complaints
What should nursing staff do to limit medications and treatments available to the client?
Collaborate with medical staff
How should nursing staff respond if physical complaints dominate the conversation?
Withdraw attention from physical complaints
What should nursing staff encourage the client to do to identify relationships between stress and symptoms?
Keep a diary of stresses and symptoms
What should nursing staff minimize in their response to physical complaints?
Time and attention given to complaints
Which nursing diagnosis is appropriate for hypochondriasis/illness anxiety disorder?
Ineffective coping
What is a common characteristic of clients with somatization disorder?
Exaggerated physical symptoms
What is a key difference between clients with illness anxiety disorder and somatization disorder?
Illness anxiety disorder involves fear of serious illness, while somatization disorder involves exaggerated physical symptoms
What is an expected immediate outcome for nursing care of clients with somatization disorder?
Client participation in the treatment program
What is a characteristic of clients with hypochondriasis?
Focus on bodily functions and rumination about illness
What is an expected community outcome for clients with somatization disorder?
Eliminating overuse of medications
What is the recommended approach for nursing interventions when dealing with clients with conversion reactions?
Avoid discussing physical symptoms and withdraw attention if necessary
What is the purpose of avoiding attention to physical complaints in clients with conversion reactions?
Minimizes secondary gain and shifts client's focus
What should be the expectation regarding client participation in activities and privileges?
Expect client to participate in activities fully and avoid granting special privileges or excuses
What should the nursing interventions focus on when dealing with clients with conversion reactions?
Client's feelings, home/work situations, and relationships
What skills should be taught to clients and their families as part of nursing interventions for conversion reactions?
Stress management, interpersonal dynamics, and conflict resolution strategies
What is the role of the nursing process in dealing with clients with conversion reactions?
Involves thorough investigation of physical health status
What is crucial for long-term behavior change in clients with somatic symptom illness?
Educating the client and their family about hypochondriacal behavior and the treatment plan
What is important to minimize the need to use physical symptoms to express negative emotions in clients with somatic symptom illness?
Encouraging the client to express feelings directly, including negative emotions like anger and resentment
What is essential to help the client plan to meet their needs in more direct ways?
Consistent support to help them develop skills in expressing feelings directly
What is important for effective treatment of clients with somatic symptom illness?
Discussing and reducing secondary gains, such as attention or escape from responsibilities, with the client and their significant others
What is crucial to teach the client and their family about when working with clients who somatize?
Hypochondriacal behavior and the treatment plan
What is commonly used as a nursing diagnosis when working with clients who somatize?
Ineffective coping
Study Notes
Psychiatric Nursing Care for Clients with Somatic Symptom Illness
- It is important to talk to the client about their feelings, especially fear and helplessness, and encourage them to express and reflect on their emotions.
- The client may have difficulty expressing feelings directly, and consistent support is needed to help them develop these skills.
- Encouraging the client to express feelings directly, including negative emotions like anger and resentment, can minimize the need to use physical symptoms to express them.
- Educating the client and their family about hypochondriacal behavior and the treatment plan is crucial for long-term behavior change.
- Discussing and reducing secondary gains, such as attention or escape from responsibilities, with the client and their significant others is important for effective treatment.
- It is essential to help the client plan to meet their needs in more direct ways and provide positive reinforcement for healthier behavior.
- Avoiding special privileges and reducing the benefits of illness can help the client cope with physical symptoms as a coping strategy.
- Teaching the client healthful daily living habits, stress management techniques, and the possible connection between caffeine and anxiety symptoms is crucial.
- Clients with somatic symptom illness are unlikely to be employed, often lose jobs due to excessive absenteeism, and have difficulty fulfilling family roles.
- They may report a lack of family support and understanding and have few friends, spending most socialization time with members of the health care community.
- Clients somatizing often have sleep pattern disturbances, lack basic nutrition, and get no exercise, and may be taking multiple prescriptions for pain or other complaints.
- Nursing diagnoses commonly used when working with clients who somatize include ineffective coping, denial, impaired social interaction, anxiety, disturbed sleep pattern, fatigue, and pain.
Test your knowledge of psychiatric nursing care for clients with somatic symptom illness with this quiz. Explore the strategies for communicating with and supporting clients, educating them and their families, and addressing their physical and emotional needs. Learn about nursing diagnoses commonly used in this context and essential interventions for promoting healthier behavior and coping strategies.
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