Week 7 and 8 Flashcards
What are examples of communication disorders?
language disorders
speech sound disorders (lisp)
childhood-onset fluency disorder (stuttering)
social communication disorder (socially awkward)
Describe autism spectrum disorder
deficits in social and emotional interactions
repetitive behavior (stimming, preservation, echolalia)
strict routines
sensory integration dysfunction
sleep disorders
digestive disorders
feeding disorders
epilepsy
allergies
Describe mild autism
social deficit
can communicate
can function
Describe moderate autism
communication deficits
obvious repetitive behaviors
changes cause distress
Describe severe autism
severe social deficits
limited communication/nonverbal
aggression
What are examples of learning disabilities?
dyslexia (words mixed up)
dyscalculia (hard time linking #s to words)
What are examples of motor disorders?
developmental coordination disorder
tourette’s disorder
Describe developmental coordination disorder
clumsy
hard time with hand writing
Describe Tourette’s disorder
mild to severe
tic disorder (motor or vocal)
early childhood onset
When would it be appropriate to diagnose a child with bipolar or mood disorder?
when it impairs functioning
Describe disruptive mood dysregulation disorder
form of depression for child 6-10 yrs
tantrums bigger than expected (not age appropriate)
Describe trichotillomania
pulling or twisting of hair
common in females
Describe excoriation disorder
skin picking
leads to lesions, infection, scarring
Describe pica
persistent eating of nonfood substances
Describe reactive attachment disorder
trauma/stress disorder
children who have inconsistent care
irritability
sadness
nightmares
regressive behaviors
Describe rumination disorder
repeated regurgitation of food, then rechewed, swallowed, or spit out
Describe avoidant/restrictive food intake disdorder
persistent failure to meet nutritional or energy needs
dependent on supplements
Describe enuresis
repeated voiding of urine voluntarily/involuntarily
ex: bed wetting
abnormal after age of 6
Describe encopresis
repeated passage of feces voluntarily/involuntarily
abnormal after age of 5
if not treated, megacolon can occur
Describe attention-deficit/hyperactivity disorder (ADHD)
persistent pattern of:
inattention
impaired ability to focus/concentrate
hyperactivity
impulsivity (poor decisions)
easily distracted, messy, fidgety
What would be implemented for a child with ADHD?
stimulation reduction (remove distractions)
enhance organization skills (planner or lists)
enhance time management (prioritization)
What medications are used for ADHD?
Stimulants:
- methylphenidate
- amphetamine salts
- lisdexamfetamine
antidepressants:
- bupropion
- atomoxetine
What are the benefits of stimulants given for ADHD?
helps to improve attention and focus
reduces hyperactive behaviors
When is the best time to give stimulants for ADHD?
in the morning
not after 4pm
What should those who are taking stimulants for ADHD be cautious about?
- weight loss (monitor 2-3x/week)
- high risk for substance abuse
- cardiovascular symptoms (chest pain/palpitations
What are the benefits of antidepressants given for ADHD?
improves anxiety or obsessive traits
What should those who are taking antidepressants for ADHD be cautious about?
few weeks to take effect
increased risk for suicide
Describe gender dysphoria
- feeling that a person is in the wrong gendered body
- strong desire to assume opposite gender
- experience embarrassment/social isolation
Describe the transition preparation for someone with gender dysphoria
- psychotherapy
- living as desired gender for 1-2 yrs
- surgical intervention
Describe oppositional defiant disorder
argue with authority or sibling
annoy others
Describe conduct disorder
physical
bully
sets fires
mean to people
steals
What is done during the assessment phase of the nursing process for a child with a mental health disorder?
ask when parents are not around
- mental health status
- observation
- substance use?
- sexual activity?
- self-harm?
- development stages (@ correct stage?)
- trauma
What are non pharmacological interventions for a child with a mental health disorder?
- parental support (important)
- group therapy
- milieu therapy
- behavior modification (reward system)
- therapeutic holding
- quiet room
- play therapy (acting out situation)
- dramatic play therapy
- therapeutic games
- bibliotherapy (using books to express feelings)
- therapeutic drawing
- music therapy
- mvmt/dance therapy
- recreational therapy
What will someone with a serious mental health illness have difficulty with?
ADLs
relationships
communication
finances
coping
What effect will someone with a serious mental illness have on their families?
difficulty coping
burnout
abuse
Describe impulse control disorders
- decreased ability to resist an impulse to perform certain acts
- knows acts are wrong
- increasing tension = sense of relief
What are examples of impulse control disorders?
intermittent explosive disorder
kleptomania
pyromania
gambling disorder
Describe intermittent explosive disorder
recurrent and unpremeditated episodes of verbal/behavioral aggression or rage
Describe kleptomania
uncontrollable urge to steal
Describe pyromania
recurring compulsion to set fires
sense of accomplishment
Describe gambling disorder
preoccupation with gambling/inability to resist urge to gamble
What are the interventions for impulse control disorders?
tension prevention
assist with managing feeling
help identify consequences w/ actions
special hairstyling
What are the treatments for impulse control disorders?
combination of psychotherapy and medications
What are examples of medications for impulse control disorders?
antidepressants
lithium
mood stabilizers
atypical antipsychotics
naltrexone (decrease impulse/cravings)
Define paraphilic disorders
sexual acts that deviate from socially acceptable behavior
What can paraphilic disorders cause?
distress
risk of harm
actual harm
Describe fetish
unusual preoccupation with object. body part, or activity to achieve sexual gratification
Describe exhibitionistic disorder
sexually aroused by exposing genitals usually to a stranger
Describe frotteuristic disorder
obtaining sexual arousal from rubbing genitals against unsuspecting others in public places
Describe pedophilia
fantasizing or actual secual activity with prepubescent child
Describe sexual masochism
sexual gratification from having pain and/or humiliation inflicted upon self
Describe sexual sadism disorder
creating psychological/physical pain in others
Describe transvestic disorder
sexual gratification by dressing as opposite gender
NOT gender dysphoria
Describe voyeuristic disorder
sexual gratification from watching unsuspecting people in sexually arousing situations
What are the interventions for someone with paraphilic disorders?
convey acceptance
assist with helpful resources
maintain boundaries
stress control strategies
assist with identifying consequences
What are the interdisciplinary treatments for paraphilic disorders?
medications (decrease impulse)
chemical/surgical castration
psychotherapy
What are the medications for paraphilic disorders?
antidepressants
naltrexone
antipsychotics
mood stabilizers
Rxs that intefere with sexual hormones
Describe chemical castration
monthly injection
Describe ageism
deeply rooted negative attitudes towards individuals due to their age
What can depression present as in older adults?
delirium or dementia
What is the treatment for depression in older adults?
psychosocial treatments
talk therapy
social support systems
ECT
antidepressants
Describe AIDS-related dementia
dementia caused by AIDS or HIV
older adults done use condoms
older women at higher risk
- skin will tear and easier to get AIDS or HIV
Describe physician assisted suicide
nurse prohibited from being involved
- make 3 requests for assisted suicide
- needs to have 6 months left to live
- 18 yrs old and resident of CA
Describe withholding of life-sustaining treatment
nurse can participate
unplugging ventilator or not giving tx if pt refuses
Define crisis
acute/time limited events
struggle for equilibrium and adjustment when problem seems unsolvable
What are the three types of crises?
developmental
situational
existential
Can more than one crisis occur at once?
yes
Define developmental crisis
normal event that leads to stress
ex: life changes, milestones
Describe situational crisis
- arises from an external source (ex: unexpected loss, recent diagnosis)
- unanticipated
- common
What does a situational crisis response depend on?
degree of support available
resiliency
overall physical & emotional health
Describe adventitious crisis
type of situational crisis
community wide
ex: natural disasters, COVID
Describe existential crisis
questioning life purpose or spirituality
can lead to:
- newfound motivation
- feelings of isolation, depression
How many phases are there of crisis? How does one move onto the next phase?
4 phases
if they can’t fix conflict, then they move to the next phase
Describe phase 1 of crisis
conflicted with conflict
responds with increased anxiety
ideal for pt to stay in phase 1 and not advance
pt uses defense mechanisms and problem solving
Describe phase 2 of crisis
threat persists
anxiety rises
functioning is disorganized
trial and error attempts begin
Describe phase 3 of crisis
trial and error fails
severe anxiety and panic
withdrawal and flight
reevaluating needs
Describe phase 4 of crisis
overwhelming anxiety
serious personality disorganization
homicidal/suicidal behavior
What is done during the assessment phase for someone who is going through a crisis?
first assess
- safety (suicidal/homicidal/hallucinations)
then assess
- patient’s perception
- situational support
- coping skills
What is implemented for someone who is going through a crisis?
Primary care
- promote mental health and reduce mental illness
Secondary care
- establish intervention during an acute crisis to prevent prolonged anxiety (safety is key)
Tertiary care
- provide support for those recovering from a disabling mental state
Define critical stress debriefing
done after traumatic situation
- allows individuals to talk about situation
- refer certain individuals to therapists
What is done during the evaluation stage for someone who is is going through a crisis?
assess pt
- feels safe?
- uses coping skills?
- level of functioning?
Define suicide
act of intentionally ending one’s life
“completed suicide”
Define suicide attempt
willful, self-inflicted, life-threatening attempt
does not end w/ death
Define suicide ideation
the process of thinking about killing oneself
What is the prevalence of suicide?
2nd leading cause of death for 15-29
males more likely, due to lethal means
women attempt more due to impulse decisions during crisis
What are the risk factors for suicide?
- health
- environmental (knows someone who committed suicide)
- historical (native americans/alaskan natives)
- genetics (suicide clusters in families)
- age (14-24 or older white men)
What is done during the assessment for someone who is suicidal?
verbal cues
behavioral cues
suicide assessment
What are the verbal cues for someone who is suicidal?
overt statements (obvious)
- I wish I were dead
covert (subtle)
- I won’t be a problem much longer
What are the behavioral cues for someone who is suicidal?
sudden
giving away possessions
putting affairs in order
neglecting hygiene
What is done during the suicide assessment?
- identify feelings
- ask directly - have you had thoughts of harming/killing self?
- ask if they have a plan
- determine lethality of plans
- gather info of risk factors
- hx of suicide?
- consult professional - safety plan
- assess social supports
What is implemented for someone who is suicidal?
don’t leave individual alone
family/community support
restrict access to lethal means
CBT
remain non judgemental and listen attentively
What happens postvention for the friends and families of those who have committed suicide?
- initiate 24-72 hours after death
post - post traumatic stress reactions
- post trauma loss debriefing
Define palliative care
supports quality of life through the end of life
Define hospice care
provided at the end of life
supports family and patient
Define loss
part of human experience
ex: loss of relationship, loss of health, loss of security
Define grief
- individualized response to a loss that is perceived, real, or anticipated
- normal response to loss at the time of death, and various reactions can occur
Describe normal grief
uncomplicated grief
resolves in 6 months
normal progression
Describe acute grief
unexpected death
can lead to exacerbation of preexisting problems (ex: relapse)
Describe anticipatory grief
living person has illness and will die
will feel anger/sadness
Describe disenfranchised grief
grief that is not publicly mourned
ex: miscarriage
Describe complicated grief
- grief that lasts more than 6 months
- can’t come to terms with death
- impairs ability to function
Describe ambiguous loss
grief of someone who is there physically, but not there mentally
or
there mentally, but gone physically
Define mourning
the way a person expresses grief and the efforts taken to manage grief
Define grief work
the process of grief recovery or how a person adjusts to the loss
What are examples of emotional responses?
grief
anger
guilt
crying
What are the four tasks of mourning?
- ACCEPT reality of loss
- PROCESS pain of grief while caring for self
- ADJUST without the deceased
- FIND an enduring connection w/ deceased
What is done during the assessment for someone who is mourning?
- identify risk factors that complicate successful completion of mourning
- identify cultural/spiritual beliefs
- assess for suicide
- assess support systems
What are examples of communication skills for the dying?
open ended questions
active listening
therapeutic presence
address spirituality
