Unit V Objectives
Disorders, Crisis and Disaster, Violence/Assault, Somatoform and Dissociative Disorders
N343
Los Angeles Harbor College
Associate Degree Nursing Program
Description:
This module deals with problems related to sensory-perceptual and cognitive changes related to somatoform and dissociative disorders.
Adaptive and ineffective processes associated with sexual assault are discussed. Crises and disaster with specialized interventions are
examined and psychiatric concepts related to eating disorders, family violence, abuse and neglect are discussed.
Estimated time of achievement: One week.
Objectives
After appropriate study of the assigned resources,
and assigned practice of the communication skills,
the nursing student will be able to:
1. Compare and contrast essential
characteristics of the somatoform and the
dissociative disorders.
2. Differentiate symptoms of somatoform
disorders from malingering, factitious
disorder and psychosomatic illness.
3. Examine the prevalence and comorbidities
of somatoform disorder.
4. Distinguish the biologic, genetic, cultural,
psychosocial factors, cognitive theory and
behavioral theory related to the etiology of
somatoform disorders.
5. Relate knowledge of the clinical
presentation and DSM-IV-TR criteria for
somatization disorder, conversion
disorder, hypochondriasis, pain disorder
and body dysmorphic disorder.
6. Distinguish the lifetime course and for
somatoform disorders.
7. Examine assessment of the patient with
somatoform disorder related to unmet
need, voluntary control of symptoms,
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Course Content
Somatoform Disorders
Prevalence
Comorbidity
Clinical presentations and DSM-IV-TR
criteria for somatization disorder,
conversion disorder, hypochondriasis, pain
disorder and body dysmorphic disorder
Etiology/Theory
Assessment of somatoform disorders
Self-assessment when working with patients
who have somatoform disorders
Nursing diagnoses
Outcome criteria
Planning
Nursing interventions
Patient evaluation
Dissociative Disorders
Prevalence
Comorbidity
Clinical presentations and DSM-IV-TR
criteria for dissociative amnesia, dissociative
fugue, dissociative identity disorder and
depersonalization disorder
Etiology/Theory
Assessment of dissociative disorders
Learning Activities
Read Varcarolis (2010). Foundations
of Psychiatric Mental Health Nursing,
6th Ed.
Chapters:
22: Somatoform and Dissociative
Disorders
16: Eating Disorders
23: Crisis and Disaster
26: Child, Older Adult, and Intimate
Partner Abuse
27: Sexual Assault
Discussion/Lecture
Clinical Experiences
Anecdotals
Daily Charting
Mental Status Assessment
Process Recordings
History and Assessments
Nursing Care Plans
Case Studies
Unit V Objectives
8.
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10.
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19.
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Disorders, Crisis and Disaster, Violence/Assault, Somatoform and Dissociative Disorders
primary gains, secondary gains, cognitive
style, ability to express needs, and
dependence on medication.
Appraise common reactions experienced
by nurses working with patients who
exhibit somatoform disorders.
Propose nursing diagnoses for patients
with somatoform disorders.
Formulate outcome criteria.
Plan for individualized interventions for a
patient with somatoform disorder.
Create interventions for the patient with
somatoform disorder focusing on
promotion of self-care activities, health
teaching, case management, and
medications.
Evaluation of outcome criteria.
Examine the prevalence and comorbidities
of dissociative disorder.
Distinguish the biologic, genetic, cultural,
and psychosocial factors related to the
etiology of dissociative disorders.
Relate knowledge of the clinical
presentation and DSM-IV-TR criteria for
depersonalization disorder, dissociative
amnesia, dissociative fugue, and
dissociative identity disorder.
Distinguish the lifetime course and for each
of the dissociative disorders.
Differentiate between generalized,
localized, continuous, and selective
amnesia.
Examine assessment of the patient with
dissociative disorder related to identity,
memory, mod, patient history, substance
use, suicide risk and impact on the family.
Self-assessment when working with patients
who have dissociative disorders
Nursing diagnoses
Outcome criteria
Planning
Nursing interventions
Patient evaluation
Eating Disorders
Prevalence
Comorbidity
Etiology/Theory
Clinical presentation and DSM-IV-TR criteria
for anorexia nervosa, bulimia nervosa, and
eating disorder NOS
Assessment of patients with anorexia and
bulimia nervosa
Self-assessment when working with patients
with eating disorders
Nursing Diagnoses
Outcome Criteria
Planning
Nursing interventions
Patient evaluation
Patient education
Psychopharmacology
Selective Serotonin Reuptake Inhibitors
Fluoxetine (Prozac)
Atypical Antipsychotic
Olanzapine (Zyprexa)
Crisis and Disaster
Comorbidity
Crisis Theory
Phases of crisis
Assessment of the patient in crisis
Self-assessment and common problems in the
N343
Student Study CD-ROM
Online Student Resources:
http://evolve.elsevier.com/Varcarolis
Audio Visuals:
3053 Domestic Violence
3054 Dying to be Thin
DVD 18 Recognizing Elder Abuse
DVD 70 Multiple Personality
DVD 72 Counseling Survivors of
Violence
DVD 77 THIN: Death by Eating
Disorder
DVD 78 From the Body Cage (Bulimia
Nervosa)
Unit V Objectives
Disorders, Crisis and Disaster, Violence/Assault, Somatoform and Dissociative Disorders
20. Appraise common reactions experienced
by nurses working with patients who
exhibit dissociative disorders.
21. Propose nursing diagnoses for patients
with somatoform disorders.
22. Formulate outcome criteria.
23. Plan for individualized interventions for a
patient with dissociative disorder.
24. Create interventions for the patient with
dissociative disorder focusing on milieu
therapy, health teaching, case management,
and medications.
25. Evaluation of outcome criteria.
26. Examine the prevalence and comorbidities
of eating disorders.
27. Distinguish the neurobiologic,
neuroendocrine, genetic, psychological and
sociocultural models related to the etiology
of eating disorders.
28. Relate knowledge of the clinical
presentation and DSM-IV-TR criteria for
anorexia nervosa, bulimia nervosa and
eating disorder not otherwise specified,
and binge eating disorder (compulsive
overeating).
29. Distinguish the lifetime course and for
eating disorders.
30. Compare and contrast the signs, symptoms
and medical complications of anorexia and
bulimia and relate each to its physiologic
cause.
31. Analyze criteria for hospital admission of
patients with eating disorders.
32. Explore common reactions experienced by
nurses working with patients who have
eating disorders.
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nurse-patient relationship when working
with patients in crisis
Nursing diagnoses
Outcome criteria
Planning
Nursing interventions
Patient evaluation
Communication guidelines
Critical Incident Stress Debriefing
Child, Older Adult, and Intimate Partner
Abuse
Prevalence
Comorbidity
Theory of family violence
Types of maltreatment
Self-assessment when working with patients
of abuse, violence or neglect
Communication guidelines
Assessment of types of maltreatment
including physical violence, child abuse,
sexual violence, emotional abuse, neglect and
economic maltreatment
Myths about family violence
Documentation
Nursing diagnoses
Nursing Interventions for children, domestic
partners, and the elderly
Primary, secondary, and tertiary prevention
Personalized Safety Guide for domestic
violence
Psychotherapy
Evaluation
Sexual Assault
Definition of sexual assault
N343
Unit V Objectives
Disorders, Crisis and Disaster, Violence/Assault, Somatoform and Dissociative Disorders
33. Propose nursing diagnoses for patients
with eating disorders.
34. Formulate outcome criteria.
35. Plan for individualized interventions for a
patient with eating disorders.
36. Create interventions for the patient with
anorexia and bulimia nervosa focusing on
milieu therapy, counseling, and health
teaching.
37. Evaluation of outcome criteria.
38. Relate knowledge of evidenced-based
treatment strategies for anorexia nervosa,
bulimia nervosa, and binge eating disorder.
39. Examine the comorbidities related to crisis.
40. Distinguish the three areas of crisis theory.
41. Differentiate among the three types of
crisis and formulate examples of each.
42. Analyze the four phases of crisis and
contrast the phases to a theoretical or
personal life experience that led to crisis.
43. Appraise the foundations for crisis
intervention.
44. Explore areas of assessment focusing on
the patient’s perception of the precipitating
event, situational supports and personal
coping skills for a patient in crisis.
45. Compare common reactions experienced
by nurses working with patients in crisis
and the interventions to promote positive
outcomes for the patient.
46. Propose nursing diagnoses for patients in
crisis.
47. Distinguish outcome criteria for the patient
in crisis.
48. Plan for individualized interventions for a
patient with acute in crisis focusing on the
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Theory
Clinical presentations of the acute and long
term phases of the Rape-Trauma Syndrome
Assessment of the sexual assault victim
Self-assessment when working with a rape
survivor
Myths about rape
Nursing Diagnosis
Outcome Criteria
Planning
Nursing intervention
Counseling strategies
Documentation
Patient evaluation
Psychotherapy
N343
Unit V Objectives
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Disorders, Crisis and Disaster, Violence/Assault, Somatoform and Dissociative Disorders
patient’s ability to carry out daily function
and the effect it is having on the significant
people in the patient’s life.
Create caring interventions for the patient
in acute crisis focusing on communication
strategies, safety, and anxiety reduction.
Evaluation of outcome criteria.
Compare and contrast the levels of nursing
care for crisis patients in primary,
secondary and tertiary prevention.
Appraise the value of critical incident stress
debriefing and categorize events in each
phase.
Examine the prevalence, comorbidities and
long-term effects of family violence.
Examine the theory of violence in terms of
stresses on the perpetrator, vulnerable
person and the environment that could
escalate anxiety to the point at which
violence becomes the relief behavior.
Compare and contrast characteristics of the
perpetrator and the vulnerable person.
Characterize behaviors of the perpetrator
and vulnerable person in each of the stages
in the cycle of violence.
Differentiate between the five types of
maltreatment: physical violence, sexual
violence, emotional violence, neglect, and
economic maltreatment.
Appraise common reactions experienced
by nurses working with patients involved
in family violence.
Explore interview guidelines.
Distinguish the areas of assessment when
interviewing a person who has experienced
family violence (setting, level of anxiety,
N343
Unit V Objectives
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Disorders, Crisis and Disaster, Violence/Assault, Somatoform and Dissociative Disorders
coping response, support system, suicide
potential, homicide potential, substance
use).
Characterize the essential elements of
documentation of family violence.
Relate legal responsibilities in reporting
family violence.
Explore myth versus fact in family violence.
Formulate nursing diagnoses for family
violence.
Distinguish outcome criteria.
Plan for individualized interventions for
family violence.
Create caring interventions for the patient
in acute crisis focusing on focusing on a
personalized safety guide and case
management
Distinguish interventions occurring in
primary, secondary and tertiary prevention
for family violence.
Evaluation of outcome criteria.
Relate knowledge of the therapeutic
modalities available for treatment of
violent families.
Examine the criteria encompassing sexual
assault.
Distinguish the relationship between the
perpetrator and victim.
Characterize the acute phase and long-term
reorganization phase of the rape-trauma
syndrome.
Appraise areas of assessment of the rape
survivor focusing on level of anxiety, usual
coping mechanisms, support system,
emotional trauma, and physical trauma.
Appraise common reactions experienced
N343
Unit V Objectives
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Disorders, Crisis and Disaster, Violence/Assault, Somatoform and Dissociative Disorders
by nurses working with sexual assault
patients.
Explore rape myths versus facts.
Characterize the consent required and
essential elements of rape examination and
documentation.
Propose the nursing diagnosis for a rape
survivor.
Distinguish outcome criteria.
Plan for individualized interventions for a
rape survivor.
Create caring interventions for the rape
survivor focusing on counseling guidelines,
patient safety, promotion of self-care
activities and discharge planning.
Evaluation of outcome criteria.
Relate knowledge of treatment modalities
available for the perpetrator and victim.
N343