Children and Adolescence Disorders Flashcards
1
Q
Pediatric Mental Status Exam
A
- appearance
- parent-child interaction
- orientation
- speech and language
- mood and affect
- thought processes and content
- social relatedness
- motor activity
- cognition
- judgement
- insight
2
Q
Cognition
A
- intellect
- problem-solving skills
- attention
- memory
3
Q
Assess Development and Functioning
A
- types of play
- social skills
- problem solving skills
- academic achievement
- energy level and motivation
- traumas, hospitalizations, injuries affecting CNS
4
Q
Assess Concerning Behaviors
A
- behaviors/changes occur across a variety of settings
- changes in sleep or appetite
- social withdrawal
- regression
- frequently appears upset, sad, or tearful
- self destructive behavior
- repeated thoughts of death
5
Q
General Collaborative Interventions
A
- play therapy**
- family therapy
- school based interventions/educational plan
- family education (meds, milieu)
6
Q
Neurodevelopmental disorders
A
- attention-deficit/hyperactivity disorder
- autism
7
Q
Disruptive, Impulse control and conduct disorders
A
- oppositional defiant disorder
- conduct disorder
8
Q
Trauma and stressor-related disorders
A
PTSD
9
Q
ADHD Myths
A
- all are hyperactive
- can never pay attention
- could behave better if wanted to
- grow out of it
- meds is best tx
10
Q
ADHD presents in toddlers as…
A
excessive motor activity
11
Q
ADHD most identified in…
A
elementary school
12
Q
ADHD most prevalent…
A
in boys
13
Q
ADHD Sx’s
A
- characterized into 3 groups
- present before age 12
- last more than 6 months, interfere with fxing and development
14
Q
3 groups of ADHD Sx’s
A
- hyperactivity
- impulsive behavior
- lack of attention
15
Q
ADHD Patho and Etiology
A
- unclear
- neurotransmitter deficits
- delay in brain maturation
- genetic factors
- biologic factors
- environmental risk factors
16
Q
ADHD Non-Pharm Tx
A
- Environmental modification
- behavioral Therapy
17
Q
Environmental modification
A
- decreasing stimulation
- calm environment
- classroom adjustments
- structured daily routine
18
Q
Behavioral Therapy
A
- rewards for desired behaviors
- consequences for problem behaviors
- point system
- established cues
- involve parents and teachers
19
Q
ADHD Pharm Therapy: Stimulants
A
-increase dopamine and norepinephrine
- Methylphenidate (Ritalin)
- Amphetamine-dextro (Adderall)
- Dexmethyl (Focalin)
- oral and patch formulations
20
Q
Side Effects of oral and patch stimulants
A
- HA
- anorexia
- insomnia
21
Q
ADHD Pharm Therapy: Non-Stimulants
A
- Atomoxetine (SNRI)
- buproprion (antidepressant)
- Clonidine (adrenergic agent)
22
Q
Clonidine Side Effect
A
- agressiveness
- impulsivity
- hyperactivity
23
Q
ADHD Nursing Interventions
A
- admin meds
- minimize environmental distractions
- implement behavioral management plans
- provide education
- promote self-esteem
- provide emotional support
24
Q
Autism Spectrum Disorder prevalence across cultures
A
equal
25
Autism Spectrum Disorder more common among...
boys (5x more common)
26
Autism Spectrum Disorder typically recognized in...
2nd year of life
27
Symptoms of Autism Spectrum Disorder range from...
mild to severe
28
Autism Spectrum Disorder sx's
impaired:
- communication
- social interaction patterns
- adapting to new situations
- attention span
- ability to organize responses to situations
-repetitive, restrictive, sterotyped behaviors
29
Autism Patho and Etiology
- unknown
- genetic
- immunologic factors
- environmental factors
30
Autism Non-Pharm therapy
- early intervention
- behavior management
- play therapy
- speech and language therapy
- PT and OT
- Gluten-free
- Vitamins
- Antacids
- Detox
31
Autism Pharm therapy
- no meds indicated for autism
| - stimulants, SSRIs, mood stabilizers manage associated symptoms
32
Autism Nursing Interventions
- prevent injury
- provide anticipatory guidance
- stabilize environmental stimuli
- provide supportive care
- enhance communication
- facilitate community-based care
33
Oppositional Defiant Disorder
- disobedient, hostile, defiant behavior
- 1-6 percent of children
- typically appears in late preschool/early school-age
- most prevalent in males than females before puberty (equal after puberty)
- 1/4 do not continue to meet diagnostic criteria over next several years
34
ODD Sx's
- angry, irritable mood
- argumentative/defiant behavior
- vindictiveness
- typically interferes with: interpersonal relationships, school performance
35
ODD Risk Factors
- genetic
- biological
- psychological
- social/environmental
36
ODD Tx
- parent management therapy (PMT)
- family therapy
- cognitive problem-solving skills training
- social skills programs
- medications for coexisting conditions
37
ODD Nursing Interventions
Behavioral Management:
- consistent rules
- address unacceptable behavior
- reinforce positive behavior
- consequences for negative behavior
38
Conduct Disorder
- behaviors that violates rules and/or rights of others
- often follows ODD but not always
- rare onset after 18 years
- sx's often present before 10 years
39
Conduct Disorder Sx's
- aggression to people and animals
- destruction to property
- deceitfulness, lying, or stealing
- serious rule violations
40
Conduct Disorder Tx
- Family therapy
- Behavioral management
- specialized residential tx
- meds for comorbidities and sx's
41
PTSD Sx's
- memories
- recurrent dreams
- disassociative rxns including flashbacks
- intense psychological distress when reminded
- play that includes elements of event
- behaviors not developmentally expected
- avoidance of reminders
- negative alterations in cognition and mood
42
PTSD
direct experience or witnessing
43
Stage One of Tx for trauma
- provide safety and stabilization
| - creating a safe and predictable environment
44
Stage Two of Tx for trauma
- reduce arousal
- find comfort from others
- overcome avoidance and work with memories
- help patient learn strategies
45
Stage Three of tx for trauma
developmental skills
- problem solving
- goal development
46
PTSD Collaborative Interventions
- trauma-focused cognitive behavorial therapy
- psychological first aid
- relaxation techniques
- meds for sx's
47
PTSD Nursing Interventions
- promote safety and nurturing
- address false beliefs immediately
- provide basic needs consistently
- reassure rxns are normal
- do not pressure to talk about feelings
- play may help
- therapeutic relationship and communication
- identify strengths/resilience factors
48
Early-Onset Disorders
- depression
- bipolar disorder
- anxiety disorder
- schizophrenia
49
Depression in toddlers
-can show regression behaviors
50
Depression in preschoolers
- destructive play
| - whine, show irritability, and lack of confidence
51
Depression in School-agres
- academic struggles
- somatic complaints
- loss of friends
- signs of boredom
- low self esteem
52
Depression in adolescents
- talk of running away
- academic struggles
- lack of involvement in activities
- poor self-care
- difficulties with parents and teachers
- focus on violence
53
Suicide
- 3rd leading cause of death
- age group most frequent
- completed suicide rare younger than 12
54
Child/Adolescent Mania Sx's
- overly silly or joyful
- sleeping little without feeling tired
- talking a lot
- extremely short temper
- unusual irritability
- engagement in high-risk behaviors
- may also have typical adult sx's
55
Child/Adolescent Anxiety
- generalized anxiety disorder sx's same as adults
| - intense worry over a long period of time
56
Separation anxiety
- developmentally inappropriate
- excessive anxiety about separation
- recurrent distress when separated
- impairs functioning
- onset prior to 18 years
57
Child/Adolescent Schizophrenia
-unusual behavior: shyness, hesitant, withdrawal, cognitive dysfx
- experience more hallucinations than delusions
- childish theme of hallucinations may be noted
- increased likelihood of experiencing developmental delay, hospitalization, more severe sx's, fx problems
