Nursing 212

Health Differences Across the Lifespan 2 Study Guide In a nursing assessment, the client recounts the trauma or severe stress. Symptoms appear in adulthood after the stressful event. Symptoms can appear immediately or may be delayed for years. Dissociation is a defense mechanism in which experiences are blocked from consciousness so that affect, behavior, identity, memories, and/or thoughts are not integrated. Repression is a defense mechanism in which thoughts and feelings are kept from consciousness. The patient may report symptoms of depression or anxiety. Facial appearances and mannerisms may vary widely within one session or appearance may vary widely from day to day. A patient’s mood is anxious or depressed. Headaches are common with DID. Some may have amnesia for events. Feelings of detachment from self or environment and feelings of physical change in the body are common. Insight is impaired, and patients are unaware of memory impairment. Conversion Disorder A conversion disorder is a somatoform disorder in which a motor, sensory, or visceral function is lost and about which the client is usually indifferent. Symptoms do not have an underlying organic cause. Motor symptoms are autism, paralysis, and tremors. Sensory symptoms are blindness, deafness, and numbness. Visceral symptoms are urinary retention, breathing difficulties, and headaches. The client has no conscious control of this disorder. Reaction to painful memories and disagreeable desires appear as physical symptoms. One example is hysterical blindness which can occur after seeing a loved one die in an auto accident. Signs and symptoms include: • Gait disturbances, paralysis, pseudo-seizures, and tremors • La belle indifference (lack of concern about the symptom or limitation on functioning) • Hypochondriasis (persistent fear or belief that one has a serious illness) Somatization Disorder The onset is usually prior to age of 30 with symptoms of several years duration. Multiple physical complaints include four pain symptoms, two GI symptoms, sexual symptoms, and symptoms suggesting neurological disorders. Lifestyle changes are evoked by physical illness, affecting occupational, family, and community relationships, and self-care, resulting in disability and inability to work, thereby leading to financial struggles. The patient seeks treatment for physical symptoms. Interventions include long term medical management, treating physical symptoms conservatively, and a “matter of fact” approach. Antidepressants can be used if depressive symptoms present, but there is no drug therapy for anxiety symptoms. Schizophrenia This is a serious disorder which affects how a person thinks, feels, and acts. Someone with schizophrenia may have difficulty distinguishing between what is real and what is imaginary, may be unresponsive or withdrawn, and may have difficulty expressing normal emotions in social situations. Contrary to public perception, schizophrenia is not split personality or multiple personality disorder. The vast majority of people with schizophrenia are not violent and do not pose a danger to others. Schizophrenia is not caused by childhood experiences, poor parenting, or lack of willpower, nor are

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