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Psych Nursing > Ch 24 Pediatrics > Flashcards

Ch 24 Pediatrics Flashcards

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1
Q

an emotional problem exists if behavioral manifestations…

A

are NOT age appropriate
deviate from cultural norms
interfere with adaptive functioning

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2
Q

strong desire for sleep or sleeping for long periods of time

A

somnolence

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3
Q

impairment in intellectual performance and adaptive skills across multiple domains

A

intellectual development disorder (IDD)

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4
Q

onset of IDD

A

prior to 18 yo

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5
Q

measured by BOTH clinical assessment and a person’s performance on IQ tests

A

general intellectual functioning

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6
Q

person’s ability to adapt to requirements of activities of daily living and expectations of their age/cultural group

A

adaptive functioning

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7
Q

predisposing factors of IDD

A 
disruptions in embryonic development (30%)
sociocultural factors (15-20%)
pregnancy and perinatal factors (10%)
genetics (10%)
general medical conditions (5%)
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8
Q

extent of severity of IDD may be measured by..

A

the client’s IQ level

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9
Q

what are the levels of IDD

A

4: mild, moderate, severe, profound

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10
Q

nursing diagnoses

A 
risk for injury
self care deficit
impaired verbal communication
impaired social interaction
delayed growth/development
anxiety
defensive coping
ineffective coping
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11
Q

what should a care plan for an IDD pt focus on

A

risk for injury, self care deficit, impaired verbal communication

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12
Q

withdrawal of child into self and into a fantasy world of his own creation

A

autism spectrum disorder (ASD)

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13
Q

who is ASD most common in

A

boys
1 in 88 children
onset is early childhood
chronic course

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14
Q

predisposing factors to ASD

A

neurological implications
physiological implications
genetics
perinatal influences

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15
Q

ASD is characterized by…

A

impairment in social interaction
impairment in communication an imaginative activity
restricted activities and interests

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16
Q

diagnoses of ASD

A

risk for self mutilation
impaired social interaction
impaired verbal communication
disturbed personal identity

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17
Q

FDA approved meds for ASD

A

Risperidone

Aripiprazole

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18
Q

what do ASD meds target

A

aggression, deliberate self injury, temper tantrums, quickly changing moods

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19
Q

dosage of ASD meds is based on…

A

weight of child and clinical response

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20
Q

side effects of Risperidone

A

drowsiness, increased appetite, nasal congestion, fatigue, constipation, drooling, dizziness, weight gain

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21
Q

side effects of Aripiprazole

A

sedation, fatigue, weight gain, vomiting, tremors, somnolence

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22
Q

essential feature of ADHD:

developmentally inappropriate degrees of…

A

inattention
impulsiveness
hyperactivity

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23
Q

types of clinical diagnosis of ADHD

A

combined type
predominately inattentive
predominately hyperactive

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24
Q

predisposing factors of ADHD

A

genetics, biochemical theory, anatomical influcence, prenatal/perinatal/postnatal, environmental, psychosocial influences

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25
Q

assessment of ADHD

A

difficulty in performing age appropriate tasks
highly distractable
extremely limited attentionspan
impulsive
difficulty forming relationships
behaviors inhibit acceptable social interactions
disruptive and intrusive
accident prone
low frustration tolerance/temper outbursts

26
Q

these are prevalent with ADHD

A

comorbid psychiatric disorders

27
Q

common comorbidities with ADHD

A

oppositional defiant disorder, conduct disorder, anxiety, depression, bipolar disorder, substance use disorder

28
Q

these may be treated cocurrently with ADHD

A

anxiety and depression

29
Q

these must be stabilized BEFORE ADHD treatment

A

substance use disorder and bipolar disorder

30
Q

nursing diagnoses for ADHD

A

risk for injury
impaired social interaction
low self esteem
noncompliance with tasks

31
Q

psychopharmacology for ADHD

A

CNS stimulants
ie/ dextroamphetamine, methamphetamine
* -phetamine

32
Q

side effects of CNS stimulants

A

insomina, anorexia, weight loss, tachycardia, decrease in growth and developmental rate

33
Q

children on ADHD drugs have….

A

increased risk of injury related hospital admissions

34
Q

presence of multiple motor tics and one or more vocal tics

A

tourette’s disorder

35
Q

prevalence of tourette’s disorder

A

more common in boys

onset is 2-6 yrs (6/7 yrs more common)

36
Q

predisposing factors of tourette’s disorder

A

biological and environmental

37
Q

simple motor tics

A

eye blinking, neck jerking, shoulder shrugging, facia grimacing,

38
Q

complex motor tics

A

squatting, hopping, skipping, tapping, retracing steps

39
Q

vocal tics

A

words/sounds, squeak, grunt, bark, sniff, short, cough, obscenities

40
Q

what other symptoms of tourette’s disorder

A

palilalia and echolalia

41
Q

diagnoses of tourette’s disorder

A

risk for self directed violence
impaired social interaction
low self esteem

42
Q

pharmacological treatments for tourette’s are most effective when…

A

combined with other therapy (ie/behavioral, individual, family)

43
Q

common meds for tourette’s

A

antipsychotics

alpha agonists

44
Q

persistent pattern of angry mood and defiant behavior that occurs more frequently than is usually observed in comparable individuals

A

oppositional defiant disorder (ODD)

45
Q

predisposing factors for ODD

A

biological

family influences: parental power struggle

46
Q

what is ODD characterized by

A 
passive aggressive behaviors**
stubbornness, procrastination
disobedience, negativism
carelessness, testing limits
resistance to directions
running away
school avoidance
temper tantrums
47
Q

how do children view themselves with ODD

A

children do not see themselves as oppositional, view problem arising from others and unreasonable demands of them

48
Q

nursing diagnoses for ODD

A

noncompliance with therapy
defensive coping
low self esteem
impaired social relationships

49
Q

persistent pattern of behavior in which the basic rights of others and major age appropriate societal norms and rules are violated

A

conduct disorder

50
Q

what are the onsets of conduct disorder

A

childhood onset

adolescent onset

51
Q

what is conduct disorder a precursor for

A

antisocial personality disorder

52
Q

predisposing factors of conduct disorder

A

biological
peer relationships
family influences

53
Q

conduct disorder is characterized by

A 
use of physical aggression in violation of rights of others
use of drugs and alcohol
sexual permissiveness
low self esteem
lack of guilt
projection
54
Q

diagnoses of conduct disorder

A

risk for violence
impaired social interactions
defensive coping
low self esteem

55
Q

essential feature is excessive anxiety concerning separation from those to whom the individual is attached

A

separation anxiety disorder

56
Q

explain separation anxiety disorder

A

anxiety exceeds what is expected for the person’s developmental level and interferes with functioning

57
Q

predisposing factors of separation anxiety

A

genetics, temperament, stressful life event, family influences

58
Q

when is the onset of separation anxiety

A

preschool age

59
Q

what does separation result in

A

tantrums, crying, screaming, clinging, complaints

60
Q

separation anxiety is characterized by

A 
reluctance to attend school
worrying
nightmares
fear of sleeping away from home
young children will shadow
61
Q

diagnoses of separation anxiety

A

anxiety (severe)
ineffective coping
impaired social interaction

62
Q

general therapeutic approaches

A

behavior, family, group, psychopharmacology

Psych Nursing (21 decks)

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