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Ch 23
Mr. D's Psychiatric Disorders
| Question | Answer |
|---|---|
| It is difficult to determine whether a child's behavior indicates | emotional problems |
| DSM-IV criteria for diagnosing childhood disorders: | 1 Not age appropriate. 2 Deviate from cultural norms. 3 Create deficits or impairments in adaptive functioning. |
| An emotional problem exists if it is manifested by | behavior |
| Nursing Interventions for children with intellectual disability. | Identify areas of deficit. Create a safe environment. Staff consistency. Info from family. |
| Mild IQ range | 50-70 |
| Mild Self-Care | Capable of independent living, with assistance during times of stress. |
| Mild Cognitive | 6th grade. Vocational skills for minimum self-support. |
| Moderate IQ range | 35-49 |
| Moderate Self-Care | Can perform some activities independently. Requires supervision. |
| Moderate Cognitive | 2nd grade. May be able to contribute to own support in sheltered workshop. |
| Severe IQ range | 20-34 |
| Severe Self-Care | May be trained in elementary hygiene skills. Requires complete supervision. |
| Severe Cognitive | Unable to benefit from academic or vocational training. Systematic habit training. |
| Profound IQ range | < 20 |
| Profound Self-Care | No capacity for independent functioning. Requires constant aid and supervision. |
| Profound Cognitive | Unable to profit from academic or vocational training. May respond to minimal training in self-help if 1 on 1. |
| Intellectual disability is an | adaptive functioning problem |
| Intellectual disability is not necessarily a | psychiatric problem |
| IEP | Individual Education Plan |
| Academic Setting of IEP addresses the | specific need of the student |
| IEP is used produced and used by | parents, teachers, student's psychologist, resource specialist, and administrators. |
| Children with psychiatric disorders will also have: | Substance abuse issues. Personality disorders. |
| There is no medical cure for | autism |
| Autism rate in boys | 1/42 |
| Boys are __ times more likely to get autism than girls. | 4 |
| Autism rate in children (including boys and girls) | 1/88 |
| _____ is the fastest growing serious developmentally disability in the US. | Autism |
| Muscular dystrophy rate in population | 1/100,000 |
| Muscular Dystrophy funding | $162,000,000 |
| Etiology of autism | Unknown |
| Early signs of autism: | Not responding to name by 12 months. No interest/pointing by 14 months. No pretend games by 18 months. Loss of speech. |
| Higher than normal risk for autism. | Boys. Siblings of those with autism. People with other developmental disorders. |
| People with autism disorder(Classical) usually have significant delays in: | language, social skills, communication, unusual behaviors and interest, intellectual disability (Low IQ) |
| Asperger Syndrome | Milder symptoms than autism. They may have social challenges and unusual behaviors and interests. |
| Asperger syndrome people typically do not have problems in: | Language and Intellect |
| Atypical disorder | Pervasive Development Disorder |
| Pervasive Development Disorder | People who meet some of the criteria for autistic disorder or Asperger syndrome, but not all may be diagnosed with PDD. (Consistency is key) |
| Autism interventions | 1 on 1, Protect from self-harm, Limit # of caregivers, + reinforcemnt for eye contact, provide children with familar objects, Assess child to recognize seperateness from others during self-care activities. |
| ADHD | Attention Deficit Hyperactive Disorder |
| ADHD is characterized by: | Inattention. Hyperactivity. Impulsive behavior. |
| ADHD predisposing factors: Biological | genetics, increased NE levels, increased dopamine levels, anatomical influences, prenatal/perinatal/postnatal exposure to stress/smoking/alcohol |
| ADHD predisposing factors: Environmental | lead, diet, psychosocial |
| ADHD outcomes | No physical harm. Interacts with others appropriately. Verbalizes positive aspects about self. Fewer demanding behaviors. Cooperates with staff. |
| Interventions for ADHD focus on | Risk for injury (impulsive behavior). Impaired social interaction (constant talking). Low self-esteem (aware of stigma). |
| Tic | Sudden brief movement or sound. |
| Age for Tourette's disorder in children | 2-12 years old. |
| Average age for Tourette's disorder | 7 years old. |
| Boys are _____ likely to get Tourette's disorder than girls. | more |
| Boys are ______ times more likely than girls to get Tourette's disorder. | 3-4 |
| Tourette's Disorder is characterized by | tics |
| Motor tics are ____ common than Verbal tics. | more |
| Simple motor tics: | eye blinking, head jerking, sticking tongue in and out |
| Complex motor tics: | touching nose, touching people, touching objects, smelling objects, obscene gestures, arm flapping, hoping, jumping |
| Simple verbal tics: | hiccups, yelling, throat clearing, barking |
| Complex verbal tics: | change in tone of voice, repeating words, echoalia, vulgar obscene expletives |
| Stress, tiredness, and excitement will ______ tics. | increase |
| Some tics can evolve or | disappear |
| Tics ______ during teenage years. | increase |
| Possible cause of tics | genes, increased levels of dopamine, increased levels of serotonin, |
| Tourette's disorder treatment: | Discuss behaviors that are not acceptable. Develop a trusting relationship with the client. Redirect violent behavior with physical outlets for frustration. Medication |
| Tourette's disorder Meds | Psychotropics (typical): Haldol, causes EPS. Ritalin and adderall. |
| Conduct disorder is a precursor to ________ personality disorder. | Antisocial |
| Conduct disorder behaviors: | Aggression to people and animals. Destruction of property. Theft. Serious rule violations. Deceit. |
| Conduct disorder predisposing factors: | Traumatics life experience. Child abuse. Genetic. |
| General medical conditions acquired during infancy or childhood account for about __% of cases of mental retardation. (infections, poisonings, physical trauma) | 5% |
| Between ___% and ___% of cases of mental retardation are attributed to deprivation of nurturance and social, linguistic, and other stimulation, and to severe mental disorders, such as autistic disorder. | 15%-20% |
| Nsg Dx of Impaired Social Interaction. S & Sx: | Intrusive and immature behavior. |
| Nsg Dx of Impaired Social Interaction. Nsg Ax: | Develop a trusting relationship. Discuss acceptable and unacceptable behaviors. Consequences for unacceptable behavior. Provide group situations for client. |
| Nsg Dx of Impaired Social Interaction. Outcomes: | Develop trusting relationship with nurse. Interact with peers appropriately. |
| Nsg Dx of Low Self-Esteem. S & Sx: | Denies responsibility. Blames others. Ridicules others. |
| Nsg Dx of Low Self-Esteem. Nsg Ax: | Ensure goals are realistic. Plan activities that provide opportunities for success. Convey unconditional acceptance and positive regard. + reinforcement for acheivements. |
| Nsg Dx of Low Self-Esteem. Outcomes: | Verbalizes + statements about self. Fewer demanding behaviors. |
| ODD | Oppositional defiant disorder |
| ODD is characterised by a pattern of | negativistic, defiant, disobedient, and hostile behavior toward authority figures |
| ODD typically begins by ___ yrs old. | 8 yrs old |
| Etiology of ODD: | Parental problems in discipling, structuring, and limit setting. Parental unavailability (seperation, evening work hours) |
| In an effort to help the child with mild to moderate mental retardation develop satisfying relationships with others, which nsg intervention is most appropriate? | Set limits on behavior that is socially inappropriate. |
| The child with autistic disorder has difficulty with trust. With this in mind, which of the following nursing actions would be most appropriate? | Assign the same staff person as often as possible to promote feelings of security and trust. |
| Which of the following nursing diagnoses would be considered the priority in planning care for the child with autistic disorder? | Risk for self-mutilation evidenced by banging head against the wall. |
| Which of the following activities would be most appropriate for the child with ADHD? | Volleyball |
| Which of the following groups are most commonly used for drug management of the child with ADHD? | CNS stimulants. (methylphenidate [Ritalin]) |
| The child with ADHD has a nursing diagnosis of impaired social interaction. Which of the following are the most appropriate intervention for this child? | Set limits with consequences on inappropriate behaviors. Provide rewards for appropriate behaviors. Provide group situations for the child. |
| The Nsg History and assessment of an adolescent with a conduct disorder might reveal all of the following behaviors except: | Feelings of the guilt associated with the exploitation of others. |
| Certain family dynamics often predispose adolescents to the development of conduct disorder. Which of the following patterns is thought to be contributing factor? | Parents who are alcohol dependent. |
| Which of the following is least likely to predispose a child to Tourette's disorder? | Absence of parental bonding. |
| Which of the following medications is used to treat Tourette's disorder? | Haloperidol (Haldol) |
Created by:
Sanctus Verus
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