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NRSG 329- Peds > Week 5- Mental Health > Flashcards

Week 5- Mental Health Flashcards

1
Q

2nd leading cause of death from ages 15-19

A

suicide

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2
Q

Most common pediatric mental health disorders include:

A
  1. neurodevelopment disorders
    - ADHD
    - autism
    - conduct disorder
  2. mood and anxiety disorders
    - GAD
    -PTSD
    - depression
  3. substance misuse
  4. eating disorders/disordered eating
    - anorexia nervosa
    - ARFID
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3
Q

Undiagnosed, untreated, or under-treated pediatric mental illnesses have been linked with:

6

A
  • school failure
  • suicide/self harm
  • substance misuse
  • violence
  • homelessness
  • incarceration
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4
Q

Warning signs of mental illness in children

A
  • Mood Changes
  • Intense Feelings
  • Behavior Changes
  • Problems at school
  • Unexplained weight loss/gain/change in appetite
  • Altered Sleep
  • Risk-taking behaviors
  • Altercations in secure relationships
  • Changes in previously enjoyed activities
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5
Q

THE most common neurodevelopmental disorder

A

ADHD

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6
Q

manifestations of ADHD

MIIP

A

Inattention
Increased distractibility
Poor impulse control
Motor restlessness

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7
Q

symptoms of ADHD

A

Forgetfulness
Squirming or fidgeting
Lack of fine motor control
Hard time following directions
Detaching from surroundings
Difficulty completing long-term projects
Trouble sharing or getting along with others

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8
Q

associated risk factors with ADHD

5

A

Brain injuries
Environmental toxins
Alcohol &/or tobacco use during pregnancy
Prematurity
Low birth weight

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9
Q

ADHD strongly linked to

A

genetic and biological factors
as well as psychosocial factors

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10
Q

ADHD diagnosis often made in

A

early school years (usually before age 7)

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11
Q

treatment/management of ADHD

3

A
  • individual and family therapy
    (CBT)
  • stimulant meds
    adderall (amphetamine and dextroamphetamine)
  • complementary meds
    yoga
    meditation
    nutritional counselling
    support groups
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12
Q

Autism spectrum disorder characterized by difficulties in:

3

A

Social interactions
Communication
Repetitive behaviors

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13
Q

ASD diagonis made

A

As early as 1-2 years; well established by 18 years old

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14
Q

cause of ASD

4

A
  • Advanced parental age
  • Prematurity
  • Prenatal environment
  • multiple genetic factors
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15
Q

Treatment & Management: ASD

A

No “cure”
Lots of Provincial funding in Canada
Treat any underlying conditions
Safety of the child!
Clarity
Consistency
Simplicity
Continuation

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16
Q

Common behaviors with ASD:

A

Difficulty making eye contact
Rare enjoyment of activities
Difficulty conversing with others
Fixated on an object or subject (talking about it all the time)
Trouble understanding others’ emotions
Intense interest in numbers, details, facts, etc.
Repeating certain behaviours
Getting upset by a change in routine
More sensitive in sensory input (light, noise, etc)

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17
Q

Oppositional Defiant Disorder (ODD) develops

A

gradually with increasing expression of defiance, negativism, argumentativeness, loss of temper, hostility, & resistance

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18
Q

ODD risk factors

5

A

Over or under parenting
Low IQ
Child Abuse
Family Conflicts
Antisocial parents

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19
Q

ODD is frequently comorbid with

3

A

mood disorder, ADHD and anxiety

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20
Q

treatment ODD

4

A
  1. Medication – many show improvement with
    - SSRI (Prozac, Zoloft, Paxil etc)
  2. Counseling or problem-solving therapy
  3. Group therapy
    - To develop listening, communication and problem- solving skills
  4. Family therapy
    - Teach parents behavior management strategies for communication and negotiating
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21
Q

Anxiety disorders are intense

A

worries that go beyond the common fears for that age group

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22
Q

4 features of anxiety

A

Anxiety interferes with the child’s ability to enjoy life or complete ADLs
The reason behind the worry is often unknown or unclear
Logical explanation of the worry does not decrease the worry
Can be aided by effective treatment

23
Q

complications of anxiety

W DISS

A

Insecurity
Strained relationships
Withdrawal from age-appropriate activities
Decreased school/cognitive performance
“Self-medicating” (older children)

24
Q

treatment of anxiety

5

A

CBT
Family therapy
Supportive & Interpersonal therapy
Acceptance & Commitment Therapy
Medications

25
Common symptoms of anxiety include:
Nervous On edge Extreme fears Trembling, sweating, SOB, aches, etc. Sleep disturbances
26
Reactionary anxiety disorder, occurs after a ___ May follow
- life-threatening event (or one that is perceived as such) - single traumatic event or longstanding repeated events (child abuse)
27
Symptoms of ptsd generally occur within
one month of the event
28
ptsd symptoms | 4
Denial Dissociation Emotional changes May also exhibit regression, separation anxiety and fearfulness (younger children
29
treatment of ptsd | 3
Psychotherapy Family therapy Medications
30
most common mental health condition in adolescence
depression
31
symptoms of MDD
Fatigue Suicidal ideation Feelings of worthlessness Decreased school performance Changes in personal relationships Weight loss/gain Change in attitude Increased isolation Loss of pleasure in usual activities
32
treatment of MDD | 5
Find underlying cause if there is one (i.e., event) Psychotherapy Harm reduction Hospital admission Medications
33
suicide facts males vs females
males are more likely to engage in suicide attempts & completed suicides, while female are more likely to engage in self-harming behaviors
34
interventions for self harm
Talking it out Offer stickers or felt markers for skin Creative alternatives Provide something to occupy their hands (stress ball, elastic) Offer distraction Journaling
35
complications of substance misuse | 4
Overdose Addiction Dependance Tolerance
36
anorexia nervosa is
- An intense fear of gaining weight Obsessive about losing weight & being thin - eat very little (even healthy foods), even if hungry - distorted body image Insist they are too fat or too big; even when dangerously underweight
37
diagnosis of AN
Low weight Failed to gain weight for normal growth & development Complications
38
Signs of anorexia:
- keep, hide, pick at, crumble or throw away food - cut food into small pieces or move it around the plate - spend much of their time focusing on food, reading recipes, preparing food for others - wear baggy clothes or layers of clothing to hide weight loss, or to keep warm - over-exercise (exercising even when it interferes with other activities, at inappropriate times, or despite injuries or other medical complications) - withdraw from friends and become secretive - engage in binge-eating episodes and/or purging (vomiting or other ways of trying to control weight/shape after eating)
39
Complications of anorexia:
anxiety, mood swings, depression irritable weak, lack of energy dizzy, headaches low blood pressure stomach or intestinal problems low body temperature loss of bone density hair loss or thinning soft, fine hair that grows on the face and body (lanugo) tooth pain dehydrated breathless slowed heart rate abnormal heartbeat or heart attack stomach takes too long to empty kidney failure infertile, unable to have children dry, yellow skin joint pain swollen hands or feet insomnia changes to hormone levels (for girls and women) irregular or no menstrual periods (for boys and men) low testosterone levels
40
Avoidant Restrictive Food Intake Disorder (ARFID) more common in
younger children
41
Avoidant Restrictive Food Intake Disorder (ARFID) very similar to ______ but
AN no body distortion
42
Avoidant Restrictive Food Intake Disorder (ARFID) can sometimes be because of | 2
physiological issues (GI) psychological issues (phobias of certain foods or textures)
43
Treatments for Eating disorders & disordered eating | 5
Medical stability Medications - Antidepressants - Anti-anxiety - Antipsychotics Nutritional Counselling Psychotherapy Family therapy
44
Nursing Interventions for Mental illness
1. Decrease noise when possible (i.e., music, yelling, loud games, horseplay) 2. Encourage a calm activity (i.e., board game, puzzle, card, meditation, reading) 3. Maintain routine when able (i.e., normal wake-up, check-in and sleep hygiene) 4. Decrease lighting 5. Provide time for 1:1 for listening and validation 6. Provide opportunity for exercise when able (courtyard, walk, treadmill) 7. Cultural connection (i.e., spiritual care consult, smudging, restorative space visit) 8. De-clutter the space, simple décor that considers safety as much as possible 9. Distract and encourage discussions about meaningful objects, photos or story-telling 10. Adequate assessment
45
What are the best kinds of psychological therapies available to patients who suffer from AN?
CBT FBT
46
Signs of autism spectrum disorder that can be revealed during the physical examination
- Lack of eye contact; not looking at objects pointed to by the examiner. * Not pointing to himself * Not letting needs be known * Perseverative play activities * Unusual behavior such as hand-flapping or spinning. * Note head circumference (macrocephaly or microcephaly may be associated with autism spectrum disorder) * Large, prominent, or posteriorly rotated ears * Asymmetry of nerve function or palsy, hypertonia, hypotonia, alterations in deep tendon reflexes, toe walking, loose gait, or poor coordination Examine the skin for hypo- or hyperpigmented lesions
47
early indications of autism in the infant and toddler. | 4
* Not babbling or using gestures by 12 months * No single words by 16 months * No two-word utterances by 24 months * Losing language or social skills at any age
48
defining characteristics of autism? | 5
severe delays in language development severe delays in understanding social relationships inconsistent patterns of sensory responses uneven patterns of intellectual functioning marked restriction of activity and interests
49
how would you recognize if anxiety is starting to interfere with daily life or become unhealthy?
- persistent excessive worry interfering with daily activities - physical symptoms like HA or stomach aches
50
some depression screening tools | 2
PHQ-9 Columbia-suicide severity rating scale
51
CRAFFT
evaluate risk and severity of substance use - car - relex - alone - forget - friends - trouble
52
3 factors associated with ADHD | NBC
- neurotransmitters - brain structure - cognitive function
53
how to psychostimulants work
facilitate the release and function of the dopamine or noradrenaline NTs

NRSG 329- Peds (6 decks)

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