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NURS 366 > Cognitive and Behavioral Disorders in Children > Flashcards

Cognitive and Behavioral Disorders in Children Flashcards

1
Q

What is any type of intellectual disability defined as?

A

Cognitive impairment

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2
Q

What are cognitive impairments classified as?

A

mild, moderate, severe, or profound

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3
Q

What are the 3 components of determining a pediatric cognitive impairment?

A

IQ (70-75 or below), functional strengths and weaknesses, 18 years or less at time of diagnosis

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4
Q

What signifies a developmental delay?

A

A significant lag in a child’s physical, cognitive, behavioral, emotional, and/or social development in respect to developmental norms

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5
Q

If a child presents with irritability, no response to contact, decreased alertness to movement/voice, delayed/difficult speech, delayed gross motor skills, feeding problems, poor/abnormal eye contact during feeding, and dysmorphic features, what may this be a sign of?

A

cognitive impairment

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6
Q

What is the nurse’s responsibility when caring for a child with impaired cognitive function?

A

Educate child/family, early intervention program recommendations, teach child self-care skills, promote child’s optimal development, encourage play and exercise, provide means of communication

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7
Q

What are examples of means of communication?

A

receptive and expressive skills, verbal and nonverbal communication

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8
Q

What is the most common chromosomal abnormality of a generalized syndrome?

A

Trisomy 21 (Down Syndrome)

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9
Q

If a patient has a separated sagittal suture, oblique palpebral fissures, small nose with depressed nasal bridge, a high, arched, narrow palate and protruding tongue, excess skin in neck folds, one palmar crease, hypotonicity and hyperflexibility and wide spaces and planar creases between big and 2nd toe, what may this child be presenting with?

A

Down Syndrome

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10
Q

What kind of congenital heart malformations do most patients with Down Syndrome present with?

A

Septal defects (ASD/VSD)

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11
Q

What is the chief cause of death (combined with cardiac abnormalities) for a patient with Down Syndrome?

A

Respiratory tract infections

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12
Q

How would a caregiver manage a patient with Down Syndrome?

A

Regular vision and hearing screenings, regular thyroid function tests, and surgical correction of serious congenital anomalies

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13
Q

What is the prognosis for life expectancy of a pt with Down Syndrome?

A

> 80% survive to age 60 years and beyond

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14
Q

What is the nurses role in caring for a child with Down Syndrome?

A

Support family, Assist family in preventing physical problems (correct positioning and support, measures to reduce Respiratory tract infections, support feeding and nutrition)

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15
Q

How would a nurse help educate a family in regards to feeding and nutrition of a child with Down Syndrome?

A

Use long, straight-handled spoon to push the food toward the back and side of the mouth
Encourage fluids & high-fiber foods to prevent constipation
Nasal saline and suction prior to feedings

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16
Q

Why would a nurse have to educate a patient who is caring for a child with Down Syndrome that when holding the baby, they must give extra support to the head and neck?

A

Patients with Down Syndrome often present with muscle hypertonicity and this will give the babies less control of their neck muscles

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17
Q

What are important aspects to consider when educating a caregiver about hygiene for an infant with Down Syndrome?

A

Babies with Down Syndrome have very dry skin, so it is important to keep the skin moisturized and frequently apply lip balm to the baby as well as using minimal amounts of soap, so the baby’s skin will not dry out more

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18
Q

What is the most common inherited cause of cognitive impairment?

A

Fragile X syndrome

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19
Q

Which gender is more severely affected by Fragile X syndrome?

A

males

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20
Q

A patient is worried that because her brother has Down Syndrome, she may be a carrier of the gene and this gene may get passed along to her children. How would you educate this patient?

A

Down Syndrome cannot be inherited and it is just as likely to have a baby with Down Syndrome whether or not someone else in your family has Down Syndrome

21
Q

A patient is discussing her pregnancy with you and begins talking about how she has been told that she is a carrier of Fragile X. She says that she is not worried that her baby will have this disorder, because this was just a chromosomal fluke that happened while she was in utero, and the baby would have just as likely a chance of getting Fragile X as a baby whose mom is not a carrier. How would you educate this patient?

A

Fragile X syndrome is a chromosomal abnormality that is inherited, so there is a good chance that her baby with either present with fragile X syndrome or will be a carrier of the gene, and this can be passed on to grandchildren as well

22
Q

Which syndrome will have an abnormal gene on the lower end of the long arm of the X chromosome?

A

Fragile X syndrome

23
Q

If a patient has 50-200 base-pair repeats of the gene mutation for fragile X, is this patient presenting with Fragile X syndrome?

A

No. This patient is a carrier of the Fragile X gene. If the patient had over 200 base-pair repeats, he/she would have Fragile X

24
Q

What would common clinical manifestations of FXS be?

A

Long, narrow face with prominent jaw (prognathism)
Large, protruding ears
Large testes (macroorchidism) in postpubertal males
Strabismus
Mitral valve prolapse and/or aortic root dilation
Hypotonia/hyperflexibility
Mild to severe cognitive impairment
ADHD/ADD and/or Autistic-like behaviors

25
Q

How can FXS be therapeutically managed?

A

Pharmacologically (serotonin agents, CNS stimulants), Multidisciplinary medical management (cardiology, neurology, and orthopedics), Early Intervention Programs (speech and language therapy, occupational therapy, special ed prn)

26
Q

What is Autism Spectrum Disorder (ASD)?

A

Complex neurodevelopmental disorder of unknown etiology
Alterations in social interaction and verbal impairment
Repetitive, restricted, and stereotyped behavioral patterns

27
Q

When will ASD symptoms typically manifest?

A

between 18-36 months

28
Q

When is ASD normally diagnosed?

A

around 2-3 years after the onset of symptoms

29
Q

How many US children have ASD?

A

1 in 68

30
Q

Is ASD more common in males or females?

A

4 times more common in males

31
Q

What gene causes ASD?

A

no specific gene causes ASD

32
Q

A caregiver is at the clinic with her child and she is refusing to give consent for the MMR vaccine for her child, because she says that her child is healthy and normal now, and if she gets the vaccine, she is going to develop autism, and she does not want to risk it. How would you educate this patient?

A

The studies that were published about a link between autism and the MMR vaccine were falsified data and there have been studies that have proven that the MMR vaccine does not give children autism

33
Q

What are the clinical manifestations of ASD?

A

Poor eye contact
Avoidance of body contact
Speech and language delay at an early age
Limited functional play
Unusual and/or odd interactions with toys
Significant gastrointestinal symptoms (e.g., constipation)
Cognitive impairment ranging from moderate to severe
Savants

34
Q

What are milestones that babies should be hitting during their infancy that children with ASD may be delayed in?

A

babbling or gesturing by 12 months
single words by 16 months
2-word phrases by 24 months

35
Q

What is the diagnostic criteria for diagnosis of ASD in children?

A

Total of 6 (or more) items from the following areas
Qualitative impairment in social interaction (at least 2)
Qualitative impairments in communication (at least 1)
Restricted repetitive and stereotyped patterns of behavior, interests, and activities (at least 1)
Delays or abnormal functioning in at least one of the following areas, with onset before age 3 years:
Social interaction
Language as used in social communication
Symbolic or imaginative play
The disturbance is not better accounted for by Rett’s disorder or child disintegrative disorder

36
Q

What is something that is Key to do when caring for a child with autism?

A

create a structured routine

37
Q

Where should the caregivers of a child with ASD refer to early?

A

Autism Society of America

38
Q

What are some things that characterize ADHD?

A

Developmentally inappropriate degrees of inattention, impulsiveness, and hyperactivity
Clinically significant impairment in social, academic, or occupational functioning

39
Q

What is important to consider when looking at a child’s behavior when diagnosing with ADHD?

A

perspective of the child’s behavior from multiple observers

40
Q

What can the Vanderbilt Assessment scale help to diagnose?

A

ADHD

41
Q

What are the characteristics of the symptoms that a child has to have if he/she is being diagnosed with ADHD?

A

6 or more, for at least 6 months, in at least 2 settings

42
Q

What are the 3 subtypes of ADHD?

A

Combined type *most common
Predominantly inattentive type
Predominately hyperactive-impulsive type

43
Q

What is key for nursing care of a child with ADHD?

A

early detection and intervention

44
Q

4 ways to manage ADHD

A

Medications
Behavioral therapy
Parenting education
Coping strategies

45
Q

3 most common types of eating disorders

A

obesity, anorexia nervosa, bulemia

46
Q

what percentile is considered obese for a child?

A

BMI greater than the 95th percentile

47
Q

What is an overweight BMI percentile for a child?

A

between 85th and 95th percentile

48
Q

What may a treatment plan include for a child with obesity?

A

Nutritional counseling/diet modification
Behavioral therapy
Group involvement
Family involvement
Increased physical activity

49
Q

What is the primary role of nursing for children with obesity?

A

Prevention

NURS 366 (29 decks)

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