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NRSG 126: Mental Health > [Exam 3] Chapter 22: Neurodevelopmental Disorders > Flashcards

[Exam 3] Chapter 22: Neurodevelopmental Disorders Flashcards

1
Q

What the essential feature of intellectual disability?

A

Below-average intellectual functioning (IQ < 70) accompanied by significant limitations in areas of adaptivie functioning such as communication, self-care, and home-living.

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2
Q

What are the degrees of disability?

A

Mild, moderate, severe, or profound

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3
Q

What heredity condiitons contribute to intellectural disability?

A

Tay-Sachs disease or fragile X chromosome syndrome

Early alterations in embryonic development like trisomy 21 or mternal alcohol intake

Fetal malnutrition, hypoxia, infections

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4
Q

What medical conditions contribute to intellectual disability?

A

Infection or lead poisoning

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5
Q

What environmental influences lead to intellectual disability?

A

deprivation of nurturing or stimulation

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6
Q

What degree of intellectual disability receive tx in their home?

A

Mild-to-moderate

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7
Q

Autism Spectrum Disorder: what is this?

A

Characterized by pervasive and usually severe impairment of reciprocal social interaction skills, communication deviance, and restricted stereotypical behavioral patterns

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8
Q

Autism Spectrum Disorder: What does this include?

A

Disorders previously categorized as different types of a pervasive developmental disorder (PDD)

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9
Q

Autism Spectrum Disorder: What are some examples of previous ppds?

A

Rett Disorder

Childhood Disintegrative Disorders

Asperger Disorder

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10
Q

Autism: Prevalent in which gender?

A

5x more prevalent in boys,

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11
Q

Autism: When autism identified?

A

By 18 months and no later than 3 years of age

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12
Q

Autism: What problems do children with autism have?

A

Persistent deficits in communication and social interaction accompanied by restricted, stereotyped patterns of behavior and interests/activites

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13
Q

Autism: Eye/facial contact here?

A

Little eye contact and make few facial expressions toward others

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14
Q

Autism: How will they act toward peers?

A

LAck spontaneous ennjoyment, express no moods or emotional affect, and may not engage in play or make believe with toys. Little intelligible speech.

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15
Q

Autism: They perform stereotyped motor behaviors which are what?

A

Hand flapping, body twisting, or head banging

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16
Q

Autism: Behaviors common for 1 year?

A

Not responding to own name

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17
Q

Autism: Behaviors common by 14 months?

A

Doesn’t show interest by pointing to objects or people

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18
Q

Autism: Behaviors common by 18 months?

A

Doesn’t play pretend games

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19
Q

Autism: Common behaviors seen here?

A

Avoids eye conact

Prefers to be alone

Delayed speech and language skills

Obsessive intereests (gets stuck on idea)

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20
Q

Autism: Percentage of kids with this at infancy?

A

80%

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21
Q

Autism: How does this affect children as they grow up?

A

Start to improve as children acquire and use language to communicate with others.

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22
Q

Autism: If behavior deteriorates in adolescence, why is this?

A

May reflectefects of hormonal changes or difficulty meeting increasingly complex social demands

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23
Q

Autism: Manifestations seen in adults?

A

Little speech and poor daily living skills throughout life to adequate social skills that allow independent functioning

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24
Q

Autism: When is short term inpatient tx indicated?

A

Used when behaviors such as head banging or tantrums are out of control

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25
Q

Autism: Goal of treatment of children?

A

Reduce behavioral symptoms and to promote learning and development, particularly the acquisition of language skills

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26
Q

Autism: Comprehensive and individualized treatment include what?

A

Special education and laguage therapy, as well as cognitive behavioral therapy for anxiety and agitation.

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27
Q

Autism: What type of drugs would be used?

A

Antipsychotics

Combo Antipsychotics

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28
Q

Autism: What antipsychotics will beused?

A

Haloperidol (Haldol)

Risperidone (Risperdal)

Aripiprazole (Abilify)

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29
Q

Autism: What do antipsychotics target?

A

Temper tantrums, aggressiveness, self-injury, hyperactivity, and stereotyped behaviors

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30
Q

Autism: what other medications can be used?

A

Naltrexone (ReVia)

Clompipramine (Anafranil)

Clonidine (Catapres)

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31
Q

Autism & Related Disorders - Tic Disorders: What is a tic?

A

Sudden, rapid, recurrent, nonrhythmic, stereotyped motor movement or vocalizations

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32
Q

Autism & Related Disorders - Tic Disorders: Examples of motor tics?

A

blinking, jerking the neck, shrugging the shoulders, grimacing, and coughing

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33
Q

Autism & Related Disorders - Tic Disorders: Example of vocal tics?

A

Repeating words or phrases out of context, coprolalia (use of socially unacceptable words, obscence), palilalia (repeaitng ones own sounds or words) and echolalia (repeating the last heard sound)

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34
Q

Autism & Related Disorders - Tic Disorders: Complex motor tics include what?

A

facial gestures, jumping, or touching or smelling an object

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35
Q

Autism & Related Disorders - Tic Disorders: What plays a part in tic disorders?

A

Abnormal transmission of the neurotransmitter dopamine

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36
Q

Autism & Related Disorders - Tic Disorders: How are tic disorders treated?

A

Risperidone (Risperdal) or Olanzapine (Zyprexa) which are atypical antipsychotics

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37
Q

Autism & Related Disorders - Tic Disorders: What is tourette disorder?

A

Involves multiple motor tics and one or more vocal tics, which occur many times a day for more than 1 year

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38
Q

Autism & Related Disorders - Chronic Motor or Tic Disorder: How does this differ from Tourette disorder?

A

In that either the motor or vocal tic is seen, but not both.

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39
Q

Autism & Related Disorders - Chronic Motor or Tic Disorder: What is a transient tic disorder?

A

May involve single or multiple vocal or motor tics, but the occurrences last no longer than 12 months

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40
Q

Autism & Related Disorders - Learning Disorders: When is this diagnosed?

A

When a child’s achievement in reading, mathematics, or written expression is below that expected for age, formal education, and intelligence.

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41
Q

Autism & Related Disorders - Motor Skills Disorders: Essential feature of developmental coordination disorder is what?

A

impaired coordination severe enough to interfere with academic achievement or activites of daily living

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42
Q

Autism & Related Disorders - Motor Skills Disorders: When does this become evident in children?

A

As they attempt to crawl or walk or as an older child tries to dress independently or manipulate toys like blocks

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43
Q

Autism & Related Disorders - Motor Skills Disorders: What is stereotypic movement disorder?

A

Characterized by rhythmic, repetitive behaviors such as hand waving, rocking, head banging, and biting that appears to have no purpose

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44
Q

Autism & Related Disorders - Motor Skills Disorders: When does stereotypic movement disorder onset begin?

A

At age 3 years and usually persists into adolescence. More common in those with intellectual disability

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45
Q

Autism & Related Disorders - Communication Disorders: What does this involve?

A

Deficits in language, speech, and communication and is diagnosed when deficits are sufficient to hinder development, academic achievement or activites of daily living

46
Q

Autism & Related Disorders - Communication Disorders: What are language disorder?

A

Involves deficits in language production or comprehension, causing limited vocabulary and an inability to form sentences or have a conversation

47
Q

Autism & Related Disorders - Communication Disorders: What is speech sound disorder?

A

Difficulty or inability to produce intelligible speech, which precludes effective verbal communication

48
Q

Autism & Related Disorders - Communication Disorders: What is stuttering?

A

Disturbance of fluency and patterning of speech with sound and syllable repetitions

49
Q

Autism & Related Disorders - Communication Disorders: What is social communication disorder?

A

Involves inability to observe social rules of conversation, deficits in applying context to conversation, inability of tell story in an understandable manner

50
Q

Autism & Related Disorders - Elimination Disorders: What is Encopresis?

A

Repeated passage of feces into inappropriate places such as clothing or the floor by a child who is at least 4 years of age or older. Involuntary often.

51
Q

Autism & Related Disorders - Elimination Disorders: What is Enuresis?

A

Repeated voiding of urine during the day or night into clothing or bed by a child at least 5 years of age

52
Q

Autism & Related Disorders - Elimination Disorders: How can enuresis be treated?

A

With Imipramine (Tofranil), an antidepressant with a side effect of urinary retention

53
Q

Autism & Related Disorders - Elimination Disorders: Both elimination disorders respond to behavioral appracohes such as what?

A

Pad with a warning bell and to positive reinforceent for coninence.

54
Q

Autism & Related Disorders - Elimination Disorders: What is sluggish cognitive tempo (SCT)?

A

Includes daydreaming, trouble focusing and paying attention, mental fogginess, staring, sleepiness, little interest in physical activity, and slowness in finishing tasks

55
Q

ADHD: What is this?

A

Characterized by inattentiveness, overactivity, and impulsiveness

56
Q

ADHD & Onset/Clinical: How are infants described?

A

As often fussy and temperamental and have poor sleeping patterns

57
Q

ADHD & Onset/Clinical: How are toddlers described?

A

As “always on the go” and “into everything”, at times dismantling toys and cribs.

58
Q

ADHD & Onset/Clinical: Why do peers perceive them as more aggressive, bossier, and less likable?

A

Perception results form the child’s impulsivity, inability to share or take turns, tendency to interrupt, and failure to listen to and follow directions

59
Q

ADHD & Onset/Clinical: Secondary complications of ADHD?

A

Low self-esteem and peer rejection

60
Q

ADHD & Onset/Clinical: Approximately 70-75% of adults with ADHD have at least one coexisting psychiatric diagnosis, such as

A

social phobia, bipolar disorder, major depression, and alcohol dependence.

61
Q

ADHD & Etiology: What increases the likelihood of ADHD?

A

Combined factors such as environmental toxins, prenatal influences, herediy, and damage to brain structure.

Prenatal exposure to alcohol, tobacco, and lead, and severe malnutrition

62
Q

ADHD & Etiology: Brain images of people with ADHD suggest what?

A

decreased metabolism in the frontal lobes, with are esential for attention, impulse control, organization, adn sustained goal-directed acitivty.

63
Q

ADHD & Etiology: Glucose in the brain?

A

It is decreased usage in the frontal lobes

64
Q

ADHD & Etiology: What is the genetic link for ADHD?

A

Abnormalities in catecholamine and possibly serotonin metabolism.

65
Q

ADHD & Etiology: Risk factors for ADHD?

A

Family history of ADHD, male relatives with antisocial personality disorder or alcholism, female relatives with somatization disorder, lower socioeconomic status

66
Q

ADHD & Cultural Considerations: What is the Child Behavior Checklist, Teacher Report Form, and Youth Self Report?

A

For those 11-18, are rating scales frequrntly used to determine problem areas and competencies

67
Q

ADHD & Cultural Considerations: What is the ADHD-FX?

A

Proven to be a valid, reliable and culturally appropriate measure of functional impairment of at risk students

68
Q

ADHD & Psychopharmacology: Medications often effective in doing what?

A

decreasing hyperacativity and impulsiveness and improving attention, enabling child to partcipate in school and family life

69
Q

ADHD & Psychopharmacology: Most common medications?

A

Methyphenidate (Ritalin) and Ampheamine compound (Adderall).

70
Q

ADHD & Psychopharmacology: How effective is methylphenidate?

A

70-80% of children, reducing hyperactivity, impulsivity, and mood lability and helps child pay attention more

71
Q

ADHD & Psychopharmacology: What stimulants used to treat ADHD?

A

Dextroamphetamine (Dexedrine) and Pemoline (Cylert)

72
Q

ADHD & Psychopharmacology: Common side effects of Dextroamphetamine and Pemoline?

A

Insomnia, loss of appetite, and weight loss or failure to gain weight

73
Q

ADHD & Psychopharmacology: What forms are methyphenidate, dextroamphetamine, and amphetamine available in?

A

Sustained release form taken once daily

74
Q

ADHD & Psychopharmacology: How else is methyphenidate available ?

A

In transdermal patch

75
Q

ADHD & Psychopharmacology: Which drug is least likely to be prescribed?

A

Pemoline, because it can cause liver damage

76
Q

ADHD & Psychopharmacology: When stimulants are not effective, what drug is used then?

A

Antidepressants. Atomoxetine (Strattera). It is a selective norepinephrine reuptake inhibitor

77
Q

ADHD & Psychopharmacology: Side effects of atomoxetine?

A

decreased appetite, nausea, vomiting, tiredness and upset stomach

78
Q

ADHD & Psychopharmacology: What can atomoxetine cause?

A

Liver damage as well.

79
Q

ADHD & Psychopharmacology: Dosage of methyphenidate?

A

10-60 mg in 3-4 divided doses

80
Q

ADHD & Psychopharmacology: Dosage of sustained release mathylphenidate?

A

20-60 mg/day in monring

81
Q

ADHD & Psychopharmacology: Dosage of dexotramphetamine?

A

5-40 mg/day in 2-3 doses

If sustained, 10-30 mg/day in morning

82
Q

ADHD & Psychopharmacology: Dosage of Amphetamine?

A

5-40 mg/day in 2-3 divided doses.

If sustained, 10-30 mg/day in morning

83
Q

ADHD & Psychopharmacology: Dosage of Atomoxetine?

A

40-80 mg/day in 1 or 2 divided doses

84
Q

ADHD & Strats for Home/School: Effective approaches include what?

A

Providing consistent rewards and consequences for behavior, offering consistent praise, and using time-out and giving verbal reprimands

85
Q

ADHD & Strats for Home/School: What happens in therapuetic play?

A

Play techniques are used to understand the child’s thoughts and feelings and to promote communication

86
Q

ADHD & History: How will parents report their children?

A

As fussy and having problems as infant. May have difficulties in major life areas such as school or play?

87
Q

ADHD & General Appearance & Motor: How will they do motor wise?

A

Cannot sit still in chair and squirms and wiggles while trying to do so.

88
Q

ADHD & General Appearance & Motor: Speech here?

A

Unimpaired but child cannot carry on a conversation.

89
Q

ADHD & Mood / Affect: Mood here?

A

Labile, even to point of verbal outbursts. Anxiety, frustration, and agitation are common.

90
Q

ADHD & Sensorium and Intellect: What is impaired here?

A

Ability ot pay attention or concentrate. Attention span may be as litle as 2-3 seconds or 2-3 minutes.

91
Q

ADHD & Judgement/Insight: Judgement here?

A

Poor judgement and often do not think before acting. They fail to perceive harm and danger.

92
Q

ADHD & Interventions: How can nurse provide childs safety?

A

Stop unsafe bhaviors

Provide close supervision

Give clear directions about acceptable and unacceptable behavior

93
Q

ADHD & Interventions: Improved role performance how?

A

Give positive feedback for meeting expecations

Manage the environment

94
Q

ADHD & Interventions: How so simplify instructions/directions

A

Get childs full attention

Break complex tasks into small steps

Allow breaks

95
Q

ADHD & Interventions: How to allow structured daily routine?

A

Establish a daily schedule

Minimize changes

96
Q

ADHD & Self Concept: How is self-esteem in child?

A

Low. Because they are not successful at school, may not have many friends ,and have trouble getting along at home.

97
Q

ADHD & Roles: How are roles?

A

Unsuccesful because frequently disruptive and intrusive at home.

98
Q

ADHD & Intervention - Ensuring Safety: What do do if child potentially engaged in dangerous activity?

A

Stop behavior. Involves physical intervention if child runing into street or jumping form a hihg place.

99
Q

ADHD & Intervention - Ensuring Safety: How should adult talk to child about bad behavior?

A

Use short and clear words. Should not assume that childs knows acceptable behavior

“It’s unsafe to do that. Do this instead now”.

100
Q

ADHD & Intervention - Improving Role Performance: What is important here?

A

To give child specific positive feedback when he or she meets stated expectations.

“You did a good job of asking to play with guitar and waiting until it was your turn”>

101
Q

ADHD & Intervention - Improving Role Performance: How does managing the environment help?

A

Helps child imrpove their ability to listen, pay attention, and complete tasks

102
Q

ADHD & Intervention - Simplifying Instructions: How do you do this?

A

Break up tasks. This prevents overwhelming child. Instead of saying clean up your room, you can now say to put your dirty clothes in the hamber.

103
Q

ADHD & Intervention - Promoting Structured Daily Routine: What does this promote?

A

Child accomplishing getting up, dressing, doing homework, playing, and going to bed.

104
Q

ADHD & Intervention - Providing Family Education and Support: What does this include?

A

Include parents in planning

Focus on childs strengths

TEach proper medicine administration.

Assist identifying behavioral approaches

Help achieve balance of praising child and correct behavior

105
Q

ADHD & Mental Health Promotion: What assessment tool can be used?

A

SNIP-IV Teacher and Parent Rating Scale can be used for initial evaluation in many areas of convern

106
Q

Psychiatric disorders are more difficult to diagnose in children than adults why?

A

Because childrens basic development is incomplete and they may lack ability to recognize or to describe what they are experiencing

107
Q

Disorders of childhood and adolescnce most often encourntered in mental health settings is what?

A

ASD and ADHD

108
Q

Intellectual disability below 70 is accompanied by what signs?

A

significant limitations in adaptive functioning, such as communication, self-care, self-direction, academic achievement, work, adn health and safety

109
Q

Most commont tic disorder?

A

Tourette disorder

110
Q

Tic disorders are treated succesfully with what?

A

Atypical antipsychotic meds

111
Q

elimination disorders cause impairment for child based on what?

A

response of parents, level of self-esteem, and degree of ostracism by peers

112
Q

asd includes a continuum approach to developmental disorders characterized y what?

A

Severe impairment of reciprocal social interaction skills, communication deviance, and restricted and stereotyped behavioral patterns

NRSG 126: Mental Health (24 decks)

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