Ch 24 Pediatrics Flashcards by Christina Stafstrom

an emotional problem exists if behavioral manifestations…

are NOT age appropriate
deviate from cultural norms
interfere with adaptive functioning

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strong desire for sleep or sleeping for long periods of time

somnolence

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impairment in intellectual performance and adaptive skills across multiple domains

intellectual development disorder (IDD)

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onset of IDD

prior to 18 yo

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measured by BOTH clinical assessment and a person’s performance on IQ tests

general intellectual functioning

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person’s ability to adapt to requirements of activities of daily living and expectations of their age/cultural group

adaptive functioning

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predisposing factors of IDD

disruptions in embryonic development (30%)
sociocultural factors (15-20%)
pregnancy and perinatal factors (10%)
genetics (10%)
general medical conditions (5%)

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extent of severity of IDD may be measured by..

the client’s IQ level

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what are the levels of IDD

4: mild, moderate, severe, profound

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nursing diagnoses

risk for injury
self care deficit
impaired verbal communication
impaired social interaction
delayed growth/development
anxiety
defensive coping
ineffective coping

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what should a care plan for an IDD pt focus on

risk for injury, self care deficit, impaired verbal communication

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withdrawal of child into self and into a fantasy world of his own creation

autism spectrum disorder (ASD)

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who is ASD most common in

boys
1 in 88 children
onset is early childhood
chronic course

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predisposing factors to ASD

neurological implications
physiological implications
genetics
perinatal influences

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ASD is characterized by…

impairment in social interaction
impairment in communication an imaginative activity
restricted activities and interests

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diagnoses of ASD

risk for self mutilation
impaired social interaction
impaired verbal communication
disturbed personal identity

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FDA approved meds for ASD

Risperidone

Aripiprazole

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what do ASD meds target

aggression, deliberate self injury, temper tantrums, quickly changing moods

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dosage of ASD meds is based on…

weight of child and clinical response

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side effects of Risperidone

drowsiness, increased appetite, nasal congestion, fatigue, constipation, drooling, dizziness, weight gain

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side effects of Aripiprazole

sedation, fatigue, weight gain, vomiting, tremors, somnolence

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essential feature of ADHD:

developmentally inappropriate degrees of…

inattention
impulsiveness
hyperactivity

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types of clinical diagnosis of ADHD

combined type
predominately inattentive
predominately hyperactive

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predisposing factors of ADHD

genetics, biochemical theory, anatomical influcence, prenatal/perinatal/postnatal, environmental, psychosocial influences

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assessment of ADHD

difficulty in performing age appropriate tasks highly distractable extremely limited attentionspan impulsive difficulty forming relationships behaviors inhibit acceptable social interactions disruptive and intrusive accident prone low frustration tolerance/temper outbursts

these are prevalent with ADHD

comorbid psychiatric disorders

common comorbidities with ADHD

oppositional defiant disorder, conduct disorder, anxiety, depression, bipolar disorder, substance use disorder

these may be treated cocurrently with ADHD

anxiety and depression

these must be stabilized BEFORE ADHD treatment

substance use disorder and bipolar disorder

nursing diagnoses for ADHD

risk for injury impaired social interaction low self esteem noncompliance with tasks

psychopharmacology for ADHD

CNS stimulants ie/ dextroamphetamine, methamphetamine * -phetamine

side effects of CNS stimulants

insomina, anorexia, weight loss, tachycardia, decrease in growth and developmental rate

children on ADHD drugs have....

increased risk of injury related hospital admissions

presence of multiple motor tics and one or more vocal tics

tourette's disorder

prevalence of tourette's disorder

more common in boys | onset is 2-6 yrs (6/7 yrs more common)

predisposing factors of tourette's disorder

biological and environmental

simple motor tics

eye blinking, neck jerking, shoulder shrugging, facia grimacing,

complex motor tics

squatting, hopping, skipping, tapping, retracing steps

vocal tics

words/sounds, squeak, grunt, bark, sniff, short, cough, obscenities

what other symptoms of tourette's disorder

palilalia and echolalia

diagnoses of tourette's disorder

risk for self directed violence impaired social interaction low self esteem

pharmacological treatments for tourette's are most effective when...

combined with other therapy (ie/behavioral, individual, family)

common meds for tourette's

antipsychotics | alpha agonists

persistent pattern of angry mood and defiant behavior that occurs more frequently than is usually observed in comparable individuals

oppositional defiant disorder (ODD)

predisposing factors for ODD

biological | family influences: parental power struggle

what is ODD characterized by

``` passive aggressive behaviors** stubbornness, procrastination disobedience, negativism carelessness, testing limits resistance to directions running away school avoidance temper tantrums ```

how do children view themselves with ODD

children do not see themselves as oppositional, view problem arising from others and unreasonable demands of them

nursing diagnoses for ODD

noncompliance with therapy defensive coping low self esteem impaired social relationships

persistent pattern of behavior in which the basic rights of others and major age appropriate societal norms and rules are violated

conduct disorder

what are the onsets of conduct disorder

childhood onset | adolescent onset

what is conduct disorder a precursor for

antisocial personality disorder

predisposing factors of conduct disorder

biological peer relationships family influences

conduct disorder is characterized by

``` use of physical aggression in violation of rights of others use of drugs and alcohol sexual permissiveness low self esteem lack of guilt projection ```

diagnoses of conduct disorder

risk for violence impaired social interactions defensive coping low self esteem

essential feature is excessive anxiety concerning separation from those to whom the individual is attached

separation anxiety disorder

explain separation anxiety disorder

anxiety exceeds what is expected for the person's developmental level and interferes with functioning

predisposing factors of separation anxiety

genetics, temperament, stressful life event, family influences

when is the onset of separation anxiety

preschool age

what does separation result in

tantrums, crying, screaming, clinging, complaints

separation anxiety is characterized by

``` reluctance to attend school worrying nightmares fear of sleeping away from home young children will shadow ```

diagnoses of separation anxiety

anxiety (severe) ineffective coping impaired social interaction

general therapeutic approaches

behavior, family, group, psychopharmacology

Ch 24 Pediatrics Flashcards

(62 cards)