Childhood Disorders

Question 1

• intellectual abilities significantly below average (less than 70)
• significant difficulty with cognitive, social, or self-care skills

Answer 1

intellectual disability

Question 2

four classes of intellectual disability severity

Answer 2

mild, moderate, severe, and profound

Question 3

epidemiology of intellectual disability

Answer 3

appx 1% of the population

Question 4

etiology of intellectual disability

Answer 4

• exposure to toxins in utero (alcohol)
• maternal illness & infection (rubella)
• genetic conditions (Down’s syndrome)
• birth complications (umbilical cord wrapped around neck)
• exposure to toxins in childhood (lead poisoning)
• physical trauma in childhood (shaken baby syndrome)

Question 5

nursing interventions for intellectual disabilities

Answer 5

• maintain a safe environment
• promote as much autonomy in self-care as possible
• when teaching self-care: Use simple, concrete speech. Focus on one learning need at a time. Teach one step at a time. Give positive reinforcements
• Try to learn nonverbal signs of client becoming upset & respond early
• Seek guidance from caregivers re: client’s nonverbal & idiosyncratic communication patterns

Question 6

*“self”-ism - locked in their own world

Answer 6

autism spectrum disorder

Question 7

the understanding that other people’s thoughts & feelings can be different from their own

Answer 7

theory of mind

Question 8

characteristics of autism spectrum disorder

Answer 8

• little interest in others; rarely make eye contact; disliked being touched
• less likely to engage in imaginative play
• poor “theory of mind”
• may have impaired language skills and trouble interpreting nonverbal communication
• may have odd, repetitive behaviors
• many rigidly adhere to routines and become upset with changes
• may develop an intense fascination in unusual topics
• some are hypersensitive to sensory input; others seem indifferent to pain or temperature

Question 9

• within the autism spectrum
• without the language impairment
• old term; this diagnosis is no longer used
• now classified as a mild form of autism

Answer 9

asperger’s disorder

Question 10

epidemiology of autism spectrum disorder

Answer 10

• appx 2.5% in the US
• 4x more common in boys
• recent increase probably due to changes in diagnostic criteria and increased public awareness

Question 11

etiology of autism spectrum disorder

Question 12

effective treatments for autism spectrum disorder

Question 13

pharmacotherapy for autism spectrum disorder

Question 14

nursing interventions for autism spectrum disorder

Question 15

• a combination of hyperactivity, impulsivity, inattention (present in varying degrees)
• behaviors present in multiple settings
• behaviors exceed normal childhood immaturity, causing significant impairment

Answer 15

attention-deficit/hyperactivity disorder (ADHD)

Question 16

hyperactive-impulsive presentation of ADHD

Question 17

inattentive presentation of ADHD

Question 18

adult ADHD

Question 19

epidemiology of ADHD

Question 20

etiology of ADHD - biological

Question 21

etiology of ADHD - environmental

Question 22

effective treatments for ADHD

Question 23

nursing interventions for ADHD

Question 24

disorder that presents with multiple motor tics and at least one vocal tic, present for more than one year

Answer 24

tourette’s disorder

Question 25

examples of common motor tics

Answer 25

blinking, shrugging, grimacing, head jerking

Question 26

examples of common vocal tics

Answer 26

noises, grunting, coughing, obscene words (coprolalia), and repeating oneself (palilalia)

Question 27

epidemiology of Tourette’s disorder

Answer 27

0.5% in the United States
4x more common in males
average age of onset: 6 years
usually declines as clients age
comorbidity (ADHD, OCD, ODD) is common

Question 28

etiology of Tourette’s disorder

Answer 28

exact etiology is unknown

combination of genetic, neuroanatomical, environmental, and social factors

Question 29

effective treatments for Tourette’s disorder - psychotherapy

Answer 29

behavioral technique - Habit Reversal Training
teaches clients to recognize signs that a tic is about to occur; client learns to perform a voluntary movement that is incompatible with a particular tic

Question 30

effective treatments for Tourette’s disorder - pharmacotherapy

Question 31

nursing interventions for Tourette’s disorder

Question 32

disorder in which clients demonstrate unusually high levels of anger and opposition to rules and authority figures; symptoms are present for greater than six months

Answer 32

oppositional defiant disorder

Question 33

additional characteristics of oppositional defiant disorder (ODD)

Answer 33

• persistent state of annoyance
• spiteful and argumentative
• every mistake they make is someone else’s fault
• can be a precursor to conduct disorder

Question 34

disorder in which clients are physically and verbally aggressive; more severe than/progression of ODD; present for at least 6 months

Answer 34

conduct disorder

Question 35

additional characteristics of conduct disorder

Answer 35

• little regard for laws or the rights and feelings of others
• misbehaviors include destruction of other people’s property, lying, and theft
• they get into serious trouble at school and usually have encounters with the justice system
• can develop into Antisocial Personality Disorder in adults

Question 36

epidemiology of oppositional defiant disorder

Answer 36

estimated between 2%-16%
much more common in males before puberty
after puberty, rates are roughly equal

Question 37

epidemiology of conduct disorder

Answer 37

prevalence estimated to be 2%-10%

more common in males

Question 38

etiology of ODD/CD - psychosocial factors

Answer 38

Ineffective parenting patterns:

• authoritarian parenting styles
• parental rejection
• lack of supervision
• inconsistent or harsh punishments
• affiliation with peers that teach/encourage delinquent behaviors

Question 39

etiology of ODD/CD - biological factors

Answer 39

genetics likely play a role; precise mechanism is unknown

Question 40

effective treatments for ODD/CD - psychotherapy

Question 41

effective treatments for ODD/CD - pharmacotherapy

Question 42

nursing interventions for ODD/CD