Chapter 22: Tourette's Syndrome

Question 1

Tourette’s Syndrome (TS)

Answer 1

a TIC disorder

• inherited neuropsychiatric disorder with an onset in childhood
• characterized by multiple physical (motor) tics and at least one vocal (phonic) tic
• premonitory urge prior to the tic
• tics can be repressed temporarily

Question 2

Signs + Symptoms

Answer 2

often exhibit symptoms of other disorders, similar to OCD, autism spectrum disorders, and ADHD
-children with coexisting disorders are more likely to suffer depression, low self-esteem, negative peer acceptance, and poor school performance than those with tics alone
>eye blinking
>neck jerking
>abdominal tensing
>touching
>stomping
>facial contortions
>retracing steps
-symptoms can last from several hundred milliseconds to several seconds or longer

Question 3

Diagnostic Tools

Answer 3

• child may have both multiple motor and one or more vocal tics present at some time but not necessarily concurrently
• tics occur several times a day
• tics occur almost every day or intermittently throughout a period of more than 1 year
• onset of tics is before age 18 years
• disturbance is not caused by the direct physiological effects of a substance or a general medical condition

Question 4

Nursing Care

Answer 4

-must recognize the impact the disorder has on the child’s functioning and social relationships
-nurse can help family members understand child cant control the tics
-child may become self-conscious and worried that he will blurt out words or utterances at inopportune times, so the nurse uses active listening
-child may also be shunned or laughed at by peers who do not understand the behavior; professional counseling may be needed
>Tic disorders do not often cause impairment of daily living; many of the manifestations are actually mild
-Nursing interventions geared toward helping the family and child cope with the disorder

Question 5

Educations/Discharge

Answer 5

• parents educated the fact that this disorder may create stress for the child and may experience low self-esteem
• nurse can help parents watch for signs that the child is being bullied by peers or sibling
• instruct family to watch for signs of coexisting disorders such as ADHD or OCD