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NUR329 Psych > Peds Neuro and Trauma > Flashcards

Peds Neuro and Trauma Flashcards

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1
Q

what are r/f for childhood mental illness

A

-family hx (genetics)
-neurobiology
-temperament
-abuse/trauma
-low socioeconomic status
-parenting

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2
Q

what symptoms do children provide better?

A

internal symptoms

e.g. mood, sleep, SI

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3
Q

What symptoms do parents provide better?

A

external symptoms

e.g. behavior relationships

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4
Q

what is different about a child/adolescent assessment?

A

-use simple phrases
-corroborate info with adult
-direct questions not open ending
-use play media
-may not be able to provide accurate time-line

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5
Q

what is important when assessing preschoolers?

A

use play! have difficulty putting feelings into works

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6
Q

what is important when assessing school agers?

A

establish a rapport, use competitive games

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7
Q

what is important when assessing adolescents?

A

have increase egocentric thoughts and behaviors. let them know what information will and will not be shared with parents

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8
Q

what is included in the developmental assessment?

A

-intellectual function
-gross motor function
-fine motor function
-cognition
-thinking and perception
-social interaction and play

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9
Q

what are the two kinds of communication disorder?

A

-speech
-language

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10
Q

what does a speech disorder entail?

A

-problems in making sounds

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11
Q

what does a language disorder entail?

A

difficulty understanding or using words in context and appropriatley

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12
Q

What are the 3 subtypes of motor disorders?

A
  1. developmental coordination disorder
  2. stereotypic movement disorder
  3. tic disorders
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13
Q

s/s of a developmental coordination disorder?

A
  • impairments in motor skill development
    -coordination below developmental age
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14
Q

s/s of a stereotypic movement disorder ?

A

repetitive purposeless movements for 4 or more weeks

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15
Q

s/s of a tic disorder?

A

sudden nonrhythmic and rapid motor movements or vocalizations

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16
Q

what are the 2 types of tic disorder?

A
  1. Tourette’s
  2. persistent motor or vocal (more than a year)
  3. provisional tic disorder (less than a year)
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17
Q

what are the treatments for tic disorders?

A

-behavioral techniques
-relaxation strategies
-meds (antipsychotics, clonidine, klonopin. fluoxetine, and sertraline)
-deep brain stimulation

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18
Q

what are the three learning disorders?

A
  1. dyslexia (reading)
  2. dyscalculia (math)
  3. dysgraphia (written expression)
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19
Q

what areas do those with IDD have deficits in?

A

-intellectual functioning
-social functioning
-daily functioning

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20
Q

what can increase levels of function in those with IDD?

A

cognitive and social stimulation if begun before 5 years

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21
Q

what factor determines adult productivity in those with IDD?

A

Motivational Support

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22
Q

what increases quality of life in those with IDD?

A

-early identification and intervention

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23
Q

what should be assessed in someone diagnosed w/ IDD?

A

-delays
-signs of neglect or abuse

24
Q

what are the main s/s of autism spectrum disorder?

A

-defecits in social interactions and relationships
-stereotypical speech and behaviors
-fixed interest
-over adherence to routines or rituals
-hyper or hypo reactivity to sensory
-extreme resistance to change
-appears in early childhood

25
Q

what should be assessed in someone with ASD?

A

-intellectual/developmental delays
-communication skills
-social skills
-behavioral skills
-parent-child relationship
-abuse
-stereotypic behavior

26
Q

what is the treatments used with ASD?

A

-behavior management
-parent teaching
-PT/OT
-2nd gen antipsychotics
-SSRI
-stimulants

27
Q

Define ADHD?

A

persistent pattern of inattention, hyperactivity, and impulsiveness that is pervasive and inappropriate for developmental level and effecting 2 of the following: work, social, or educational difficulties before age 12

28
Q

what are the three types od ADHD?

A
  1. hyperactivity-impulsivity
  2. inattentive
  3. combined
29
Q

What is needed to diagnose ADHD hyperactivity-impusilsivity?

A

six or more of the following for 6 months
Hyperactivity behaviors
* Often fidgets; moves feet; squirms in seat; can’t sit still
* Leaves seat before excused
* Runs about/climbs excessively or at inappropriate times
* Difficulty playing quietly (e.g. Board games)
* Is often “on the go” or often acts as if “driven by a motor”
* Often talks excessively/ non-stop talkers
Impulsivity behaviors
* Often blurts answers before questions finished; speaks before thinking
* Often interrupts or intrudes on others (Butts into conversations or
games)
* Problem waiting for his/her turn

30
Q

what is needed to diagnose ADHD inattentive?

A

six or more of the following for 6 months

Does not give attention to details or makes repeated careless
mistakes
* Trouble keeping attention on tasks or activities
* Often does not seem to listen when spoken to directly
* Does not follow through with completion of task/activity
* Often has trouble organizing activities
* Avoids, dislikes doing tasks that involve mental effort
* Loses things, distracted, or forgetful
* Easily bored
* Disorganized

31
Q

how do we treat ADHS?

A

-behavior management
-parent training
-increase problem solving and coping skills
-group therapy
-stimulants
-nonstimulants

32
Q

what are not effective treatments for ADHD?

A

-play therapy
-CBT

33
Q

what do stimulants do?

A

improve attention and FOCUS to decrease hyperactivity

34
Q

what is important when dosing stimulants in children?

A

NOT weight dependent
start low and work your way up

35
Q

what are the long acting stimulants?

A

-dextroamphetamine/amphetamine
* lisdexamfetamine
* dexmethylphenidate
* methylphenidate

36
Q

what are the intermediate acting stimulants?

A
  • dextroamphetamine
  • methylphenidate
37
Q

what are the short acting stimulants

A
  • methylphenidate (Ritalin)
  • dexmethylphenidate
  • dextroamphetamine
  • amphetamine sulfate
38
Q

s/e of stimulants

A

decreases appetite, h/a, nausea, insomnia, jittery, social withdrawal, tachy or brady, HTN, restlessness

39
Q

what are the non stimulants?

A

–atomoxetine (SNRI)
–buproprion (NDRI)
-clonidine
–guanfacine
–imipramine

40
Q

what is important to monitor for with atomoxetine?

A

SI

41
Q

what are some practical tips for someone with ADHD?

A

-schedule
-organize everyday items
-be specific, clear, and consistent
-give praise when rules are followed
-set and reward small attainable goals

42
Q

what are the three impulse control disorders?

A
  1. oppositional defiant disorder
  2. conduct disorder
  3. intermittent explosive disorder
43
Q

what is the common age of onset for ODD?

A

~8 years old

44
Q

what are the clinical features for ODD?

A

-angry/irritable
-argumentative
-vindictiveness
-recognizes others have rights and rules
-don’t think they are angry and blame others

45
Q

r/f for ODD

A

-family hx of mental illness
-neurobiology
-family dysfunction
-adverse childhood events
-temperamental

46
Q

what is the treatment for ODD?

A

-parent training
-group therapy
-anger management
-individual and family therapy
-cognitive problem solving training
-divalproex (to control anger and aggression)

47
Q

when is the onset of conduct disorder?

A

late childhood/early adolescence

48
Q

what are the clinical features of conduct disorder?

A

unimpulsive violation of the rights of others
-aggression to ppl and animals
-destruction of property
-deceitfulness
-rules violation
-does NOT feel guilty

49
Q

r/f for conduct disorder

A

-physical and sexual abuse
-lack of supervision
-inconsistent and harsh parenting
-early institutional living
-parental substance abuse
-biology

50
Q

treatment for conduct disorder

A

-meds: antidepressant, mood, stimulants, antipsychotics, anticonvulsants, and adrenergic
-family support
-psychosocial
-anger mgmt
-parent training

51
Q

r/f for intermittent explosive disorder

A

-neurobiological abnormalitites
-conflict or violence in family

52
Q

age of onset for intermittent explosive disorder

A

can be diagnose at age 6
commonly diagnosed 13-21 years

53
Q

clinical features of intermittent explosive disorder

A

-impulsive and unwarranted emotional outbursts
-violence
-destruction of property

54
Q

what helps prevent worsening intermittent explosive disorder?

A

early treatment

55
Q

what are some psychosocial interventions of all impulse control disorders?

A
  1. Promote a climate of safety for the patient and for others.
  2. Establish rapport with the patient.
  3. Set limits and expectations.
  4. Consistently follow through with consequences of rule-breaking.
  5. Provide structure and boundaries.
  6. Provide activities and opportunities for achievement of goals to
    promote a sense of purpose.
56
Q
A

NUR329 Psych (11 decks)

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