INfant, Child and Adolescent Mental Health Flashcards
Define prenatal mental health
preconception until the infant is around. 24 months old
this area considers maternal and infant mental health understands that early intervention is important to maximise health outcomes for mother and infant
What are the potential challenges a nurse may face when engaging with and assessing the health of a child
- communication issues due to developmental and/or chronological age
- parental resistance and/or consent
- access
- the restrictions, environmental restrictions, difficulty establishing a therapeutic relationship
Why are maori at a higher risk of suicide than non-maori
- risk associated with the history of colonisation
- higher rates of mental illness and AOD use
- higher rates of family violence
Anorexia Nervosa
Symptoms- restriction of energy intake with intention of weight reduction. intense fear of gaining weight, body dysmorphia
Impact- low mood, cognitive impairment, increased anxiety, pseudo sense of control, life threatening medical conditions
Bulimia Nervosa
Symptoms- eating an excessive amount of food, larger than most people would eat, over a similar period of time; then purging oneself due to feelings of fear and/or disgust
Impact- low mood, anxiety, oesophageal ulceration, teeth decay, medical complication
Binge eating disorder
Symptoms- recurrent episodes of binge eating, lack of self-control associated with distress after bingeing
Impact- marked psychological distress, significant psychiatric comorbidities
Difference between men and women who experiences eating disorders
Men- generally pursue bulking up and looking slim, aim for muscular bodies through exercise excessively, bingeing, purging steroid use.
Women- generally want to look thinner so restrict, excessively exercise and purge
Outline the physical effects/risk factors for people who experience an eating disorder
- gastrointestinal effects
- endocrine effects
- musculoskeletal effects
- dental and oral effects
- skin/integument effects
- renal dysfunction
- electrolyte abnormalities
- cardiovascular effects
- neurological effects and cognitive changes
Outline requirement for a Physical assessment on someone with an eating disorder
- ECG
- Urinalysis
- Complete blood count
- Weight
- Height
- Vital signs
- metabolic status
- cardiovascular and peripheral vascular function
Outline requirement for a Mental health assessment (including risk) assessment on someone with an eating disorder
- cognitive assessment
- MSE
- risk assessment - self (intentional and unintentional) risk of AWOL, alcohol and drugs use
- AOD assessment
- functional assessment
Outline requirement for a body image assessment on someone with an eating disorder
- distortion
- dissatisfaction
- avoidance
- body checking
Outline requirement for a nutritional and exercise assessment on someone with an eating disorder
- caffeine and smoking (appetite reduction),
- laxative use
- supplements
- weight measurement
- intak- avoidance of food groups
- excessive exercise
- water loading
- vomiting
- diuretic use
Outline requirement for a eating disordered behaviour and rituals assessment on someone with an eating disorder
- refusing to eat
- cutting up food into small pieces
- removing oils and fats
- lack of variety
- fear of touching food
- cutting out food
- eating slow/ no enjoyment
- fidgeting and take measuring food
- leaving to purge
Outline requirement for a family assessment on someone with an eating disorder
- confidentiality issues
- family support
- education
- no judgement
What is re-feeding syndrome
potentially fatal in those who are malnourished. insulin and electrolytes altered rapidly and a severe drop in phosphates can lead to sudden death
What other areas of health might you see re-feeding syndrome in?
- poverty
- older persons health
- dementia/ or delirium
- mental illness/ psychosis/ depression where functional needs aren’t met
- abuse
- prisoners of war
- anorexic patients
What is infant mental health
infant mental health refers to how well a child develops socially and emotionally from birth to three. understanding infant mental health is key to preventing and treating mental health problems of very young children and their families
Mothering myths
- a mother immediately wants. knows and lovers her baby
- maori and pacific mothers bond better with their babies because of more family support
- a mother should be able to give her full emotional self to her nany
- the birth of a baby bring contentment and happiness to a family
maternal mental health
- the most risky time for women to become mentally unwell is postpartum
- 10-15% of women experience PND
- 10% pregnant women experience depression
- 15-20% women experience anxiety while pregnant or post nataly
- 1-2% women experience BPAD while pregnant or post nataly
- 0.5% of women experience post natal psychosis
what can influence maternal mental health
- biology
- psychology, temperament and resilience
- social situation and supports
- previous pregnancy and birth experience
- trauma
- drug and alcohol use
- cultural perceptions
bonding
- getting to know a baby and having the baby get to know a primary attachment figure
- encourages parent to meet their child’s needs and respond readily
- non verbal
- reading cues
- forming attachment
- can start utero
- not immediate or expected
The maternal - infant dyad
“3 patients”
- synchronised
- needs protecting and promoting
- consider what the mother bring, what the infant brings and how this impacts on them as individuals and their relationship
- maternal sensitivity
- more valued in some cultures than others
the first 3 years
- important to determine brain structure for life
- connectivity occurs- learned through responsive relationships, nurture, learning
- adaptation to environment
- attachments
watch wait wonder
- infant led
- encourages free play
- seeks to understand emotional responses
- recommended for 0-4 years
watch: what is the child doing? what are they wanting to do? what is the child communicating? how is the adult able to allow the child to lead?
wait: i don’t need to rush in- lets give this some time and the space it needs
wonder: mentalizing, what is going on for the child? how is this for the child? why do i react or respond the way i do?
