Complete summary for, Rasmussen Mental
Health Exam 3, Complete solution. 2024/2025.
Somatoform Disorders
An umbrella group of disorders characterized by the presence of one or more physical
symptoms accompanied by abnormal thoughts, feelings, and behavioral reactions in
response to these symptoms, with NO PHYSICAL FINDINGS OR MEDICAL
ILLNESSES TO EXPLAIN THEM. These symptoms are NOT INTENTIONAL or under
the conscious control of the patient.
They may DEMAND UNNECESSARY TESTS, and may be NON-COMPLIANT with
provider recommendations. Individuals with this disorder experience significant life
impairment as a result of their symptoms, preoccupation, and high anxiety.
Often undergo unnecessary surgeries, invasive diagnostic procedures, and drug trials,
all of which can be life-threatening.
Somatoform Disorders - Nursing interventions
1. Offer explanations and support during diagnostic testing.
2. After physical complaints have been investigated, avoid further reinforcement of the
somatic complaints.
3. Spend time with the patient at times other than when he/she is expressing a physical
complaint (e.g., when talking about a pet or TV program and give the "reward" of extra
attention during those times).
4. Observe and record frequency and intensity of somatic symptoms.
5. DO NOT imply that symptoms are not real.
6. Shift focus from somatic complaints to feelings or to neutral topics.
7. ******Assess secondary gains that physical illness provides for patient, such as
attention, lack of work responsibility, or guilt of a spouse causing them to stay rather
than leave the patient.
8. Use straightforward approach to patient exhibiting resistance or covert anger.
9. Have patient direct all requests to a designated nurse or clinician.
10. Show concern for patient, but avoid fostering dependency needs.
11. Reinforce patient's strengths and problem-solving abilities.
,12. Teach assertive communication skills and techniques.
13. Teach patient stress reduction techniques, such as meditation, relaxation, and mild
physical exercise.
Important thing to remember regarding the assessment of a patient with
somatoform disorder
When patients complain of physical symptoms, TAKE THE SYMPTOMS SERIOUSLY.
Even if a medical explanation is not found understandable, the symptoms are real and
distressing to the patient.
Working with people who have somatic symptom disorders can be frustrating, and you
and other staff may find yourself avoiding interaction with them. However, when people
feel they are receiving care and attention, the intensity of symptoms tends to diminish.
As the symptoms are alleviated and **RAPPORT IS ESTABLISHED, it becomes easier
to address emotional issues.
Secondary Gains
Benefits that a person might be receiving from the symptoms they are having.
Example: the patient is not able to perform the usual family, work, and social functions,
and receives extra attention from loved ones.
If a patient derives personal benefit from the symptoms, relinquishing the symptoms is
more difficult.
Hypochondriasis (Illness Anxiety Disorder)
Preoccupied with having or eventually developing a serious illness. Patients with this
disorder may or may not present with somatic symptoms, and if they do, the symptoms
are usually mild.
What they do exhibit is a high level of anxiety and alarm about their health lasting at
least 6 months, and may either excessively check for problems or avoid medical care. It
is important to consider other possible diagnoses such as anxiety disorders.
They are more alarmed by the potential implications of any disorder than with the
disorder itself, and are alarmed with any new bodily sensations. Patients can
misinterpret normal physical sensations such as sweating, abdominal cramping, or
awareness of heartbeat as indicative of disease.
Conversion Disorder
Disorder that presents with one or more symptoms of impaired motor or sensory
function. The deficit causes significant distress to the patient and impaired social or
occupational functioning.
Symptoms include weakness or paralysis, abnormal movement, swallowing or speech
difficulties, seizures or attacks, sensory loss or anesthesia, or symptoms involving the
senses (blindness or loss of smell).
Nursing Interventions for Conversion Disorder
, Use a straight forward approach
Be supportive, yet ASSERTIVE with them
Pt independence is IMPORTANT, they need to be able to take care of THEMSELVES.
Don't do everything for them!
Dissociative Disorders
A disturbance in the normally well-integrated continuum of consciousness, memory,
identity, and perception.
Dissociation is an unconscious defense mechanism to protect the individual against
overwhelming anxiety RELATED TO PAST TRAUMA, and ranges from minor to severe
in presentation.
Patients with dissociative disorders have intact reality testing, meaning they are not
delusional or hallucinating. People with these disorders routinely experience significant
emotional pain and struggle with overall functioning and safety.
Dissociative Fugue
Often associated with dissociative amnesia, which is amnesia related to a traumatic
accident. Fugue is when the patient flees from their normal life to another location and
starts a new life.
Gradually over time, memories of the original life may be triggered. Patients can
become confused and embarrassed when the amnesia subsides and memory returns.
Interventions for Dissociative Disorders
1. Ensure patient safety by providing safe, protected environment and frequent
observation.
2. Provide non-demanding, simple routine.
3. Confirm identity of patient and orientation to time and place.
4. Encourage patient to do things for self and make decisions about routine tasks.
5. Assist with other decision making until memory improves.
6. Support patient during exploration of feelings surrounding the stressful event.
7. Do not overwhelm patient with data regarding past events.
8. Allow patient to progress at own pace as memory is recovered.
9. Provide support during disclosure of painful experiences.
10. Accept patient's expression of negative feelings.
Health Exam 3, Complete solution. 2024/2025.
Somatoform Disorders
An umbrella group of disorders characterized by the presence of one or more physical
symptoms accompanied by abnormal thoughts, feelings, and behavioral reactions in
response to these symptoms, with NO PHYSICAL FINDINGS OR MEDICAL
ILLNESSES TO EXPLAIN THEM. These symptoms are NOT INTENTIONAL or under
the conscious control of the patient.
They may DEMAND UNNECESSARY TESTS, and may be NON-COMPLIANT with
provider recommendations. Individuals with this disorder experience significant life
impairment as a result of their symptoms, preoccupation, and high anxiety.
Often undergo unnecessary surgeries, invasive diagnostic procedures, and drug trials,
all of which can be life-threatening.
Somatoform Disorders - Nursing interventions
1. Offer explanations and support during diagnostic testing.
2. After physical complaints have been investigated, avoid further reinforcement of the
somatic complaints.
3. Spend time with the patient at times other than when he/she is expressing a physical
complaint (e.g., when talking about a pet or TV program and give the "reward" of extra
attention during those times).
4. Observe and record frequency and intensity of somatic symptoms.
5. DO NOT imply that symptoms are not real.
6. Shift focus from somatic complaints to feelings or to neutral topics.
7. ******Assess secondary gains that physical illness provides for patient, such as
attention, lack of work responsibility, or guilt of a spouse causing them to stay rather
than leave the patient.
8. Use straightforward approach to patient exhibiting resistance or covert anger.
9. Have patient direct all requests to a designated nurse or clinician.
10. Show concern for patient, but avoid fostering dependency needs.
11. Reinforce patient's strengths and problem-solving abilities.
,12. Teach assertive communication skills and techniques.
13. Teach patient stress reduction techniques, such as meditation, relaxation, and mild
physical exercise.
Important thing to remember regarding the assessment of a patient with
somatoform disorder
When patients complain of physical symptoms, TAKE THE SYMPTOMS SERIOUSLY.
Even if a medical explanation is not found understandable, the symptoms are real and
distressing to the patient.
Working with people who have somatic symptom disorders can be frustrating, and you
and other staff may find yourself avoiding interaction with them. However, when people
feel they are receiving care and attention, the intensity of symptoms tends to diminish.
As the symptoms are alleviated and **RAPPORT IS ESTABLISHED, it becomes easier
to address emotional issues.
Secondary Gains
Benefits that a person might be receiving from the symptoms they are having.
Example: the patient is not able to perform the usual family, work, and social functions,
and receives extra attention from loved ones.
If a patient derives personal benefit from the symptoms, relinquishing the symptoms is
more difficult.
Hypochondriasis (Illness Anxiety Disorder)
Preoccupied with having or eventually developing a serious illness. Patients with this
disorder may or may not present with somatic symptoms, and if they do, the symptoms
are usually mild.
What they do exhibit is a high level of anxiety and alarm about their health lasting at
least 6 months, and may either excessively check for problems or avoid medical care. It
is important to consider other possible diagnoses such as anxiety disorders.
They are more alarmed by the potential implications of any disorder than with the
disorder itself, and are alarmed with any new bodily sensations. Patients can
misinterpret normal physical sensations such as sweating, abdominal cramping, or
awareness of heartbeat as indicative of disease.
Conversion Disorder
Disorder that presents with one or more symptoms of impaired motor or sensory
function. The deficit causes significant distress to the patient and impaired social or
occupational functioning.
Symptoms include weakness or paralysis, abnormal movement, swallowing or speech
difficulties, seizures or attacks, sensory loss or anesthesia, or symptoms involving the
senses (blindness or loss of smell).
Nursing Interventions for Conversion Disorder
, Use a straight forward approach
Be supportive, yet ASSERTIVE with them
Pt independence is IMPORTANT, they need to be able to take care of THEMSELVES.
Don't do everything for them!
Dissociative Disorders
A disturbance in the normally well-integrated continuum of consciousness, memory,
identity, and perception.
Dissociation is an unconscious defense mechanism to protect the individual against
overwhelming anxiety RELATED TO PAST TRAUMA, and ranges from minor to severe
in presentation.
Patients with dissociative disorders have intact reality testing, meaning they are not
delusional or hallucinating. People with these disorders routinely experience significant
emotional pain and struggle with overall functioning and safety.
Dissociative Fugue
Often associated with dissociative amnesia, which is amnesia related to a traumatic
accident. Fugue is when the patient flees from their normal life to another location and
starts a new life.
Gradually over time, memories of the original life may be triggered. Patients can
become confused and embarrassed when the amnesia subsides and memory returns.
Interventions for Dissociative Disorders
1. Ensure patient safety by providing safe, protected environment and frequent
observation.
2. Provide non-demanding, simple routine.
3. Confirm identity of patient and orientation to time and place.
4. Encourage patient to do things for self and make decisions about routine tasks.
5. Assist with other decision making until memory improves.
6. Support patient during exploration of feelings surrounding the stressful event.
7. Do not overwhelm patient with data regarding past events.
8. Allow patient to progress at own pace as memory is recovered.
9. Provide support during disclosure of painful experiences.
10. Accept patient's expression of negative feelings.
