Test 3 Mental Health of Child and Adolescent

Question 1

Biggest concern we have as nurses regarding mental health problems

Answer 1

The need to eradicate the stigma against mental health

Question 2

____% of those in the juvenile justice system have diagnosable mental health problems

Answer 2

70% have mental health problems in the juvenile justice system

Question 3

Alcohol abuse starts as early as age?

Answer 3

Starts as early as age 8

Question 4

___% of children in the welfare system have diagnosable mental health problems

Answer 4

50% of children in the welfare system have diagnosable mental health problems

Question 5

Autosomal dominant framework

Answer 5

Mental health problems, such as alcohol abuse, run in families

Question 6

Environmental framework for mental health

Answer 6

Example: mother who drinks could predispose child to mental health problems

Question 7

Erikson in child development

Answer 7

Maturationist approach to development. Individuals who mature at a certain rate and surmount the developmental task at that level are able to successfully challenge the next step. If they don’t, they’re development is interrupted and challenged, and this can pose a problem for them in the coming years.

Question 8

Ecological systems in child development

Answer 8

environment, psychosocial development, and physical development. It is the total environment that says whether or no the child will develop safely and successfully.

Question 9

• Ability to withstand stress
• Characteristics include, “good natured”, confident, sense of humor, realistic, flexible, self assured,secure.
• Demonstrate capacity to “counce back” and master stress

*Definition of ?*

Answer 9

Resilience

Question 10

___% of children who are exposed to a powerful stressor do not experience lasting developmental damage

Answer 10

80% exposed to stressor don’t experience lasting developmental changes

Question 11

• Clear thinking
• Skill in verbal language
• Understanding own emotions and also those of others
• Making friends
• Getting along with others
• Even temperament
• Responsive caregiving
• Self esteem
• Fostered competence
• Supportive adults in the environment

*All of these things are meant to ?*

Answer 11

Meant to foster resilience

Question 12

• Social relatedness impairment
• communication impairment
• restricted repertiore of behaviors (childs ability to be flexible in situations is not seen. Only one or two responses to all situations)

Answer 12

Autism

Question 13

Types of developmental disorders (4)

Answer 13

1. Mental Retardation
2. Pervasive Developmental Disorders
3. Specific Developmental Disorders
4. Tic Disorder

Question 14

True or False: As autistic children grow, they can have unusual abilities for a person of their developmental level , also called cevant abilities

Answer 14

True

Question 15

True or False: Autistic children speak later than other kids of their developmental stage, and also talk about themselves using their name

Answer 15

True

Question 16

How is autism diagnosed?

Answer 16

• There is no specific tool, assessment is used over time to diagnose.
• Child doesn’t respond to his or her name, doesn’t make eye contact, wants specific order, unusual rituals, all centered around soothing the self

Question 17

PANDAS

Answer 17

• Psychiatric and Neurological disorders associated with strep

Question 18

• Some symptoms can be alleviated using medicines “off label”
• Self harming: anti-depressants, anti-anxiety

Answer 18

Autism

Question 19

• Mild end of the autism spectrum
• intellect is intact
• Matked by social awkwardness

Answer 19

Asperger’s Disorder

Question 20

CHAT

Answer 20

Checklist for Autism in Toddlers

Question 21

• focus on symptom management
• Early detection (CHAT)
• Behavioral intervention
• Language therapies
• Occupational therapies
• Pharmacotherapy
• Social skills training

Answer 21

Nursing care for Asperger’s

Question 22

Pharmacotherapy for Aspergers

Answer 22

• Medicine to stabalize mood, decrease depression, and deal with anxiety

Question 23

3 Disruptive behavior disorders

Answer 23

1. Attention Deficit Hyperactivity Disorder
2. Conduct Disorder
3. Oppositional Defiant Disorder

Question 24

• 3 Types
• Inattentive
• Hyperactive-Impulse
• Combined: inattention and hyperactivity

Answer 24

Attention Deficit/Hyperactivity Disorder

Question 25

-Enduring pattern of disobedience, argumentativeness, explosive angry outbursts, low frustration tolerance, and a tendency to blame others for quarrels or accidents

Answer 25

Oppositional Defiant Disorder

Question 26

Use stimulating medications for this because of the "sleepy brain"

Answer 26

ADHD

Question 27

Ritalin: short acting

Answer 27

Best drug for ADHD, used multiple times a day

Question 28

Cognitive behavioral component to ADHD therapy

Answer 28

Cause and reaction problem solving component (learning strategy)

Question 29

Oppositional defiant disorder is comorbid with?

Answer 29

Comorbid with ADHD and anxiety

Question 30

* Risk factors include: Physical and sexual abuse, inconsistent or inadequate parenting, lived in institutional setting during early childhood

Answer 30

Conduct Disorder

Question 31

Characterized by serious violations of social standards such as aggression, vandalism, cruelty to animals, stealing, lying, and truancy

Answer 31

Conduct Disorder

Question 32

Rapid, jerky movements of the eyes, face, neck and shoulders or slow purposeful movements

Answer 32

motor tics

Question 33

Throat clearing, grunting, repetitive noises, words, phrases

Answer 33

Phonic tics

Question 34

Types of Tic Disorders (3)

Answer 34

1. Motor Tics 2. Phonic Tics 3. Tourette's Disorder

Question 35

Ways to deal with conduct disorder as a nurse

Answer 35

Implement some structure strategies and support for the involved family

Question 36

A combination of motor and phonic tics on a spectrum from barely discernable to extremely debilitating

Answer 36

Tourette's Disorder

Question 37

Diagnosis of Tourette's

Answer 37

Comes when symptoms are visible for at least a year

Question 38

Treatment for Tics

Answer 38

Antipsychotics, as well as behavioral therapy

Question 39

Child soiling themselves with feces in a child 4 years or older. Not the result of pre-existing medical problem

Answer 39

Encopresis

Question 40

Enuresis

Answer 40

Inability to control urination/ daytime wetting

Question 41

* A subset of children who develop OCD and/or tic disorder following a strep. infection * Autoimmune disorder * Criteria 1. Presence of OCD/tic 2. Pediatric onset (3y/o - puberty) 3. Varying severity 4. Association with A Beta-hemolytic streptococcal infection 5. Association with neurological abnormalities (motor activity)

Answer 41

Psychiatric and Neurologic Symptoms Associated with Strep (PANDAS)

Question 42

Treated with an antibiotic

Answer 42

PANDAS

Question 43

Precipitating factors for depression in adolescents include

Answer 43

* Low self-esteem * difficult relationships * academic difficulties * parental depression * bereavement

Question 44

Why increase in suicide with adolescents on antidepressants

Answer 44

Treatment starting to work enough, that they have the energy to complete the suicide plan. Paired with impulsivity of the adolescent.

Question 45

If you can do one intervention in mental health nursing care, what do you want to do?

Answer 45

Establish a therapeutic alliance

Question 46

\_\_\_\_\_\_\_ experience higher co morbidity of depression with anxiety, conduct disorders, and substance abuse than adults experience

Answer 46

adolescents

Question 47

* Often seen as part of bipolar disorder * elevated mood * increased engergy/strength * little need for sleep * restlessness * diregard for safety * rapid speech * increased irritability

Answer 47

Mania

Question 48

Ways to investigate suicide in the adolescent. How would you phrase it?

Answer 48

1. I know you're feeling very depressed, tell me about any plans you have to harm yourself/ I need to know if you're thinking about killing yourself 2. I need to know your plan/ Tell me about your plan

Question 49

* consistently below or above caloric needs to maintain a healthy weight * eating is accompanied by anxiety or guilt * eating happens in the absence of hunger and appetite is never satisfied * results in physiologic imabalances and complications to health

Answer 49

Eating Disorders

Question 50

Treatment for Mania

Answer 50

* Mood stabilizers, anti-convulsants * often don't see lithium in adolescents because of small therapeutic range, lack of compliance, and it's renally toxic