C/A Autism Spectrum Disorder Flashcards
What is the core concept that describes ASD?
a heterogenous group of neurodevelopment syndromes characterized by a wide range of communication impairments, and restricted, repetitive behaviors
what are the neurological predisposing factors that are associated with ASD?
total brain volume, amygdala, and striatum are enlarged in children younger than age 4 with evidence of the brain shrinking over time (disruption in brain plasticity contributes to ASD)
What are the genetic predisposing factors associated with ASD?
genetic mutation that expresses multiple genes
what are prenatal and perinatal predisposing factors that are associated with ASD?
Advanced perinatal age, gestational diabetes, and gestational bleeding. Exposure to toxins.
What are diagnostic criteria must be met for ASD?
Deficits in social communication and interactions: failure of normal back-and-forth conversation, reduced sharing of interest/emotions/affect, failure to initiate or respond to interactions
Deficits in nonverbal Communications: abnormalities in eye contact and body language or deficits in understanding gestures, total lack of facial expressions
Deficits in developing and maintaining relationships: difficulties adjusting behaviors to suit various social contexts, difficulties sharing in imaginary play or in making friends, absence of interest in peers
SEVERITY = Restricted, repetitive patterns, interests, or activities are manifested by at least TWO of: stereotype or repetitive motor movements or speech (lining of toys,/echolalia), insistence on sameness routines or patterns of verbal or nonverbal behavior (distress in small changes), highly restricted and fixed interest, hyper or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment (PAIN)
*symptoms must be present in early developmental period
Describe the care plan for risk for self-mutilaion in child with ASD and nursing interventions.
STG: patient demonstrates alternative behavior in response to anxiety within specified time
INTERVENTIONS: work with child on a ONE-TO-ONE basis, determine if self-mutilation behaviors are associated with increasing anxiety, intervene with diversion or replacement activities, protect child when self-mutilation behaviors occur
LTG: patient does not harm self
describe the care plan for impaired social interaction of a child with ASD and the nursing interventions.
STG: patient demonstrates trust in ONE caregiver
INTERVENTIONS: assign limited number of caregivers to child and ensure warmth and acceptance, provide child with familiar objects such as blanket or toy, give positive reinforcement for eye contact and gradually reinforce with touch
LTG: patient will initiate social interaction with a caregiver by the time of discharge from treatment (physical, verbal, nonverbal)
Describe the nursing care plan for impaired verbal communication of a child with ASD and the nursing interventions.
STG: patient establishes trust with one caregiver
INTERVENTIONS: maintain consistency in assignment of caregivers, anticipate and fulfill the child’s needs until communication can be established, seek clarification and validation, give positive reinforcement when eye contact is used to convey nonverbal expressions
LTG: patient establishes a means of communication and desires to others
Describe the nursing care plan for disturbed personal identity of a child with ASD and the nursing interventions.
STG: patient names own body parts as separate and individual form those of others
INTERVENTIONS: assist the child to recognize separateness during self-care, assisting the child in learning to name own body parts with mirrors/drawings, encourage appropriate touch
LTG: patient develops ego identity as self by DC time
What medications are used to treat irritability as a symptom of ASD? What are the side effects associated with each? What medication is commonly discontinued and what are the symptoms?
Risperidol (5-16 years)
S/E: neuroleptic malignant syndrome, tardive dyskinesia, hyperglycemia and diabetes
Abilify (6-17 years)
S/E: desertion, fatigue, weight gain, vomiting, somnolence, and tremors
DC apripiprazole when sedation, drooling, tremors, vomiting and extrapyramidal disorders are present.
