Question

Lois’s psychiatrist has admitted her to the psychiatric unit with a diagnosis of Somatic Symptom Disorder. Lois is 38 years old and has been seeing a psychiatrist off and on since she was 16 years old, when the family was deserted by her father. Lois was the oldest of five children. At that time, Lois was admitted to the hospital by the family physician for “abdominal pain.” No physical etiology was found, and the physician told Lois’s mother that Lois suffered from “nervous stomach.” Over the years, she has been treated on an outpatient basis or hospitalized for chest pain, abdominal pain, backaches, food intolerances, and fatigue. She has had a hysterectomy and a thyroidectomy. She is insisting at this time that she has a problem with her stomach that the doctor is not finding. She is very depressed and tells the nurse, “I can’t stand all this pain. I just can’t understand why the doctor can’t find my problem. I know I’m depressed, but that’s not causing my stomach pain. They need to keep looking for it.” The psychiatrist keeps reassuring Lois that no pathophysiology exists for her pain. Design a care plan for Lois.

Answer 1

The care plan for a patient with Somatic Symptom Disorder is

Nursing diagnosis :

Ineffective coping mechanism related to disease condition as evidenced by verbalisation

Goal: to make patient cope up and lead a quality life

Assessment

Subjective data:

• Stomach pain
• Feeling depressed

Objective data:

• Depressed
• Expression of abdominal pain

Nursing intervention and rationale

• Assess the patient's coping strategies , this gives the baseline information
• Provide psychotherapy, best approach to treat the symptoms
• Accept the pain of the patient,this gives a great relief to the patient
• Talk therapy can help her to understand about the actual cause and divert her mind
• Medication to relieve her depression
• Discuss about anxiety and its ill effects on body
• Provide confidence,reassurance to patient that they are listening and have concerns
• Provide positive outcome activity
• Teach diversional therapy like exercise,meditation to relax
• Family support

Evaluation

Patient should exhibit a good coping mechanism in life