Community and Mental Health: Exam 3 Flashcards
Reviewing Suicide, Schizophrenia, The Health Care System, Economics of Health Care, Child/Adolescent Care, Eating Disorders
Chapter 26: Child and Adolescent Mental Health Care
Resiliency and things in common for resilient children
Developed through successful transition through a previous crisis. Resilient children usually have more available resources, a good mentoring figure and neurologically less vulnerable to stress
Chapter 26: Child and Adolescent Mental Health Care
General Systems Theory
“A change in one family member affects all family members”, the family as a whole
Chapter 26: Child and Adolescent Mental Health Care
General Etiology of Mental Disorders in Children
Either genetic, biochemical, social and/or environmental
Chapter 26: Child and Adolescent Mental Health Care
Disruptive Mood Dysregulation Disorder (DMDD)
Severe recurrent temper outburst inconsistent with developmental level
Time: Averaging 3 or more times/week, present > 12 months
Diagnosing: Between ages 6-18
Chapter 26: Child and Adolescent Mental Health Care
General Manifestations of Autism
Unresponsive to Caregiver, Resistant to Affection, Relating to Objects more than people, Lack of Development, Repetitive Play, Acute Hearing/Touch, Sleeping Difficulties, Absence of Self-Image, Desire of Sameness
Note: Autism is on a spectrum, many variants
Chapter 26: Child and Adolescent Mental Health Care
Nursing Interventions for a Patient with Autism
- Protection from harm
- Centering around achieving full potential in cognitive and social skills
- Behavior Modification
- Play Therapy to develop trust, positive experiences with adults, creativity and reality
Chapter 26: Child and Adolescent Mental Health Care
Behavioral Disorder: ADHD
; may or may not have hyperactivity
Diagnosing: Around school age, more frequent in males
Chapter 26: Child and Adolescent Mental Health Care
Behavioral Disorder: Oppositional Defiant
Pattern of negative, defiant, and disobedient behavior toward authority figures, but don’t see themselves as defiant
Diagnosing: Usually evident before 8
Chapter 26: Child and Adolescent Mental Health Care
Behavior Disorder: Conduct Disorder
Pattern of violating basic rights and social norms of others
Diagnosing: Males tend to fight/do vandalism; Females tend to lie, be truant and run away
Chapter 26: Child and Adolescent Mental Health Care
Nursing Interventions for Behavioral Disorders
- Protect from harm
- Accountability for behavior
- Increase in ability to trust and controlling impulses
- Having positive role models
- Support and Education to Caregivers
Chapter 26: Child and Adolescent Mental Health Care
Anxiety Disorders: Separation Anxiety Disorder
Having a hard time separating from caregiver, fear of abandonment; rooted in unresolved dependent ties
Chapter 26: Child and Adolescent Mental Health Care
Anxiety Disorders: PTSD
Younger children have nightmares with monsters, threats to self, etc. and internalize anxiety
Diagnosing: In any age
Chapter 26: Child and Adolescent Mental Health Care
Anxiety Disorders: Phobias
Fears, especially of specific things that invokes great anxiety, which can peak during transitional times
Diagnosing: Most often in girls
Chapter 26: Child and Adolescent Mental Health Care
Adverse Childhood Experience (ACE) Study
Traumatic events that children go through that affect mentality and behavior, with 10 questions (4+/10 sets them up for major health concerns)
Chapter 26: Child and Adolescent Mental Health Care
Nursing Interventions for Anxiety Disorders
- Protect from panic level
- Cognitive therapy for underlying fear
- Behavior Modification, reinforcing self-control
- Help to increase self-esteem and feelings of competence
Chapter 26: Child and Adolescent Mental Health Care
Overall Interventions for Children
Involving the families, using play therapy or play and talk therapy as age appropriate, medication compliance, setting boundaries, desired behavior is rewarded, promote responsibility
Chapter 26: Child and Adolescent Mental Health Care
Important Notes for Interventions
Find common ground, show inability to be manipulated, being a role model, intervene before explosive behavior, avoid power struggles, community resources
Chapter 26: Child and Adolescent Mental Health Care
Psychopharmacology for ADHD
CNS Stimulants:
Chapter 26: Child and Adolescent Mental Health Care
Psychopharmacology for Autism Spectrum Disorder
Anti-psychotics: Risperidone and Aripiprazole
Targeting: Aggression, Self-Injury, Tantrums, Mood Changes
Chapter 26: Child and Adolescent Mental Health Care
Psychopharmacology for Autism Spectrum Disorder (AEs and Considerations)
Side Effects: Drowsiness/Dizziness, increased appetite, nasal congestion, fatigue, constipation, drooling an weight gain
AEs: EPS, hyperglycemia, diabetes
Chapter 26: Child and Adolescent
Psychopharmacology for ADHD (AEs and Considerations)
Warning: Monitor CV functioning, psychiatric symptoms may worsen
Side Effects: Insomnia, anorexia, weight loss, tachycardia, decrease in RATE OF GROWTH AND DEVELOPMENT (RITALIN)
Chapter 26: Child and Adolescent
Psychopharmacology for ADHD (Atomoxetine Specific)
MoA: Selective norepinephrine reuptake inhibitor
Warning: CV and Liver Function, Psychiatric Symptoms may worsen
Side Effects: Palpitations/Tachycardia, Anorexia/Weight loss, Nausea/Vomiting, Constipation, Liver Damage
Chapter 26: Child and Adolescent
Psychopharmacology for ADHD (Central Acting Alpha-Agonists)
Clonidine and Guanfacine
AE: Palpitations, Tachycardia/Bradycardia, Constipation, Dry mouth, Sedation
Chapter 26: Child and Adolescent
ADHD Medication Concerns
OTC medications should be avoided when child is taking stimulant medications
Drug-Drug with cold and hay fever meds could be toxic
Chapter 14: Eating Disorders
Commonality: Based on Irrational Misperception of Body Image
Irrational misperception of body image; cognitive distortions resulting of processing errors in the brain
Connected to: Anxiety, dysphoria, low self-esteem, feeling of lack of control
Chapter 14: Eating Disorders
Co-Morbities of Eating Disorders =
Mood and anxiety disorders, substance abuse, body dysmorphic disorders, impulse control disorders, personality disorders (OCD and Borderline disorders), possible suicidal ideation/self-harm
Chapter 14: Eating Disorders
Red Flags for Anorexia
- Loss of Appetitie and menstral period
- Dieting with relish
- Denial of hunger
- Excessive exercise/frequent weighing
- Use of laxatives/vomiting
- Layering clothing
- Bizarre eating habitis
- Low Tolerance for cold
- With Bulimia as well: Bathroom trips right after meals; red/raw knucles
Chapter 14: Eating Disorders
Common Characteristics with Anorexia
- Perfectionism/low self esteem
- Females from age12-25; increase in age 8-11
- Controlling over body
- Uninformed and fearing sex
- Shy, timid and neat
- High energy/achiever
- Dependent upon parents
