Final additional cards Flashcards
birth - 18 mo
trust vs mistrust
18 mo - 3 yrs
autonomy vs shame and doubt
3-6 yr
initiative vs guilt
6-12
insustry vs inferiority
Class of meds used for autism
antipsychotics
electrolyte abnormalities of anorexia
increased BUN/creatinine, decreased electrolytes, increased liver enzymes → confusion, lost of muscle/nerve function
labs bulemia
metabolic alk, electrolyte imbalance
anorexia meds
antidepressants, antipsychotics (for distored perception) antianxiety
bulimia and binge eating meds
SSRIs
weight gain goals for anorexia
0.5-1.5 lbs per week gain, with discharge goal of a BMI of 18.5-19
Cluster A
schizophrenia-like,
paranoid
schizoid
schizotypal
Paranoid
grudges, distrust, suspicion
Schizoid
detachment in social relationships, emotional coldness
schizotypal
avoidant, delusional, many hallucinate → more misperception than other types
Nursing interventions Cluster A
clear communication
promote independence
avoid power struggles
in schizoid, use meds short term
Cluster B
Sociological challenges
antisocial
borderline
histrionic
narscistic
antisocial
must be at least 18, disregard and violation of the rights of others, harm animals
borderline
perceived abandonment, polarized thinking, instability in relationships
histrionic
attention seeking
Narcissistic
needs to be admired, self centered, lack of care for others, grandiosity
cluster B nursing interventions
communicate directly
set boundaries
talk with staff about feelings, especially with borderline personality as slitting can be an issue
for histrionic, show empathy about concerns but focus on objective issues
for narcissistic, allow the patient to rechannel their “skills” to deal with illness
Cluster C
fearfulness and anxiety
avoidant
dependent
OCPD
avoidant
social inhibition, hypersensitive to negative feedback and criticism
Dependent
shy, clingy, submissive, hesitant to make own decisions
OCPD
like OCD but they don’t see a problem with it (egosyntonic)
Nursing interventions Cluster C
avoidant – calm, avoid reactions that may seem rejectant
Dependent – avoid giving a sense of uncertainty, treat patient as an equal partner, avoid making decisions for them
OCPD – avoid confrontation, reactivity, and personalizing the interaction
Intellectual developmental disorder
onset before 18, deficits in intellectual performance (IQ) and adaptive skills (ADLs) as compared to peers, 4 levels based on IQ
Autism
early onset, deficits in communication, social skills, and behavioral inflexibility, levels vary
Autism nursing interventions
routines, dopamine antagonists (antipsychotics like zyprexa, geodon, seroquel)
ADHD
inattention, impulsivity, and hyperactivity, difficulty with task completion and beginning, disruptive, low frustration tolerance
Nonstimulant ADHD meds
Atomoxetine (Strattera) SNRI, wellbutron (weak NRI)
alpha 2 agonists like clonidine and guanfacine
Stimulant OD
fluids, sz precautions, bromocriptine for fever, and anti seizure meds
Tourettes
presence of vocal and motor tics, presents in age 6-7
tourets meds
Low dose antipsychotics
alpha agonists– clonidine and guanfacine
Conduct disorder
constant violence and rule breaking without remorse, especially towards animals, before 18, at 18 converted to antisocial personality disorder
Conduct disorder interventions
Structure, supervision, therapy, meds (lithium, antidepressants, anticonvulsants)
Disruptive behavioral disorders
disruptive mood dysregulation disorder (replaced pediatric bipolar)
Oppositional defiant disorder – provocative, angry, testing limits, argumentative, vindictive
Interventions for oppositional defiant disorder
parent education
behavior modification
Situational crisis
impacts one or a small number of individuals, like a house burning down
Adventitious crisis
societal, catastrophic event impacting large groups of people like a bomb being dropped
maturational crisis
transitions, failed attempt to master developmental tasks
DBT
more in depth, involves parts of CBT, meditation and distraction, increased pt participation in their care, focuses on changing distress tolerance level and emotional regulation
most effective for more extreme cases, ED, SI, SUD, BPD
