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Pediatrics > Alteration in Cognition, Behavior, or Dev > Flashcards

Alteration in Cognition, Behavior, or Dev Flashcards

1
Q

Factor’s Influencing Children’s Behavior

A
  • biologic or genetics
  • nutrition
  • physical health
  • developmental ability
  • environment/family
  • temperament
  • family’s response to behavior
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2
Q

What are some techniques for evaluation?

A
  • clinical features
  • brain imaging
  • blood or urine toxicology
  • screening tools
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3
Q

Behavior Management Techniques

A
  • set limits and hold responsible for behavior
  • do NOT argue, bargain, or negotiate
  • consistent caregivers/daily routine
  • remain calm
  • ignore inappropriate behavior
  • praise self control
  • use restraints only when necessary
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4
Q

Psychostimulants

A

Methylphenidate TID

  • long acting preparations are given once daily in AM
  • decreased appetite; abdominal pain
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5
Q

Antianxiety

A

Buspirone

  • monitor for depression, confusion, agitation
  • may cause drowsiness
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6
Q

Antimanic

A

Lithium

  • monitor closely
  • polyuria, polydipsia
  • tremors, diarrhea
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7
Q

SSRI

A

fluoxetine, paroxetine, sertraline

  • monitor for BP increases
  • insomnia
  • GI distress
  • irritability
  • headache
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8
Q

Atypical Antidepressant

A

Trazadone

  • monitor BP for postural hypotension
  • observe for sedation and drowsiness
  • avoid alcohol
  • administer w/ meals or snacks
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9
Q

A-Agonist

A

Clonidine

  • strongly sedating
  • monitor BP and pulse
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10
Q

Tricyclic Antidepressants

A

Amitriptyline

  • monitor ECG for arrhythmias
  • monitor for anticholinergic effects
  • weight loss
  • check blood levels
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11
Q

Antipsychotics

A

Thioridazine, Chlorpromazine, Haloperidol

  • monitor for anticholinergic effects, drowsiness, dystonia, dizziness
  • drowsiness
  • evaluate for orthostatic HTN, tachycardia
  • observe for tardive dyskinesia
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12
Q

Assessments for a Child w/ Cognitive or Mental Health Disorder

A
  • health history
  • past medical history
  • history of neurologic injury or disease and family history of mental health disorder
  • developmental history
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13
Q

What are some behaviors related to mental health disorders?

A 
hallucinations 
aggression, impulsivity 
distractibility 
intolerance to frustration 
lack of sense of humor 
inhibition
poor attention span 
potential cognitive or learning disability 
unusual motor activity
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14
Q

What is the most sensitive early indicator of an intellectual disability?

A

delayed language development

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15
Q

Dyslexia

A

difficulty w/ reading, writing, and spelling

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16
Q

Dyscalculia

A

difficulty w/ math and calculations

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17
Q

Dyspraxia

A

problems w/ manual dexterity and coordination q

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18
Q

Dysgraphia

A

difficulty producing the written word

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19
Q

Sensory Processing Disorder

A

may be mistaken for a learning disability, but it is not and should be treated differently

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20
Q

What is the criteria for being diagnosed w/ an Intellectual Disability?

A
  • deviations in IQ of two or more standard deviations
  • coexisting deficits in at least 2 adaptive skills
  • disability occurring before the age of 18
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21
Q

Mild Intellectual Disability

A

IQ 50-70

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22
Q

Moderate Intellectual Disability

A

IQ 35-50

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23
Q

Severe Intellectual Disability

24
Q

Profound Intellectual Disability

A

IQ less than 20

25
What are the warning signs of autism?
- not babbling by 12 months - not pointing or using gestures by 12 months - no single words by 16 months - no 2 word utterances by 24 months - losing language or social skills at any age
26
What are some possible etiologies of autism?
- genetic makeup - brain abnormalities - altered chemistry - virus - toxic chemicals
27
Autism Screening Tools
- Checklist for Autism in Toddlers (CHAT) - Modified Checklist for Autism in Toddlers (M-CHAT) - Social Communications Questionnaire (SCQ) - Pervasive Developmental Disorders Screening Test II (PDDST-II)
28
What to look for when assessing an Autistic Child?
-lack of eye contact -failure to look at objects -failure to point to himself -failure to let his or her needs known -perseverative play activities -hand flapping spinning
29
Nursing Interventions for Autism
- provide emotional support - professional guidance and education - assess fit b/t developmental needs and treatment plan - help parent's overcome barriers - stress importance of rigid, unchanging routines - assess need for respite care - provide positive feedback
30
What is ADHD characterized by?
inattention, impulsivity, distractibility, and hyperactivity
31
What are the 3 subtypes of ADHD?
- hyperactive-impulsive - inattentive - combined
32
Tourette Syndrome
multiple motor tics and one or more vocal tics occurring either simultaneously or at different times
33
What are 2 comorbid conditions that occur 60% of the time w/ Tourette's?
ADHD | Obsessive compulsive disorder
34
When do tics become more noticeable for a child w/ Tourette's?
during times of stress
35
What are the 4 types of eating disorders?
- pica - rumination - anorexia nervosa - bulimia
36
Pica
- 2-3 years old | - ingests a nonnutritive material such as clay, paint, or sand for at least 1 month
37
Rumination
infants which regurgitate partially digested food/formula and then expel or swallow it
38
Anorexia Nervosa
dramatic weight loss as a result of decreased food intake and sharply increased physical exercise
39
Bulimia
cycle of normal food intake, followed by binge-eating and then purging
40
Complications of Anorexia Nervosa and Bulimia
- fluid and electrolyte imbalance - decreased blood volume - cardiac arrhythmias - esophagitis - rupture of esophagus or stomach - tooth loss - menstrual problems - mortality rate as high as 18%
41
Mood Disorders
- depressive disorders - bipolar disorder - anxiety disorder - mood control
42
Teaching Topics for Mood Disorders
- mood disorders are biologic conditions not personality flaws - teach how to administer antidepressant meds and monitor for adverse effects - encourage for following through w/ therapies - support family - refer to local support resources
43
What are some disorders that may be seen w/ depression?
- suicide - anxiety disorders - substance abuse - eating disorders - self harm - disruptive behavioral disorders
44
Risk Factors for Suicide
- previous suicide attempt - change in school performance, sleep, or appetite - loss of interest in formerly favorite school or other activities - feelings of hopelessness or depression - statements about thoughts of suicide
45
Types of Anxiety Disorders
- generalized anxiety disorder - social phobia - selective mutism - separation anxiety - obsessive compulsive disorder - posttraumatic stress disorder
46
Generalized Anxiety Disorder
unrealistic concerns over past behavior, future events, personal competence
47
Social Phobia
persistent fear of speaking or eating in front of others, using public bathrooms, or speaking to authority
48
Selective Mutism
persistent failure to speak
49
Separation Anxiety
close to parents; worry focuses on separation
50
Obsessive Compulsive Disorder
compulsions performed to reduce anxiety about obsessions
51
Compulsions
repetitive behavior such as cleaning, washing, checking something
52
Obsessions
unwanted and intrusive thoughts
53
PTSD
an anxiety disorder that occurs after a traumatic event
54
Types of Abuse/Violence Leading to Mental Illness
- child maltreatment - Munchausen syndrome - Substance abuse
55
Munchausen Syndrome
type of child abuse in which the parent creates a physical/psychological illness, symptoms, or impairment in the child
56
Warning Signs of Munchausen Syndrome
- child w/ 1 or more illnesses that don't respond to treatment or follow a puzzling course; similar history in siblings - symptoms that don't make sense or that disappear when the perpetrator is removed - physical & lab findings that don't fit w/ reported history - repeated hospitalizations failing to produce a diagnosis, transfers to other hospitals - parent who refuses to accept that the diagnosis is not medical

Pediatrics (24 decks)

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