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Child And Adolescent Flashcards

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1
Q

What is the first stage of Erickson’s developmental staging?

A

Trust versus mistrust

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2
Q

What ages do trust versus mistrust occurring?

A

Infancy from birth to 18 months

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3
Q

What is the second stage of Erickson’s developmental staging?

A

Autonomy versus shame and doubt

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4
Q

But what age does autonomy versus shame, and doubt take place

A

Toddler years from 18 months to three years

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5
Q

What is stage three of Ericksons developmental staging?

A

Initiative versus guilt

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6
Q

At what age does initiative versus guilt occur?

A

Preschool years from 3 to 5

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7
Q

What is stage four of Ericksons developmental staging?

A

 industry versus inferiority

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8
Q

At what age does industry versus inferiority occur

A

Middle school years from 6 to 11

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9
Q

Why is the first stage trust versus mistrust important in Erickson’s developmental staging

A

Child is utterly dependent on adult for everything they need to survive, including food, love warrants, safety, and nurturing if caregiver fails to provide adequate care and love, child will be come to feel that they cannot trust or depend on the adults in their life

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10
Q

Why is the second stage autonomy versus shame and doubt important in Erickson’s developmental staging

A

At this point in development, children are just starting to gain a little independence. They perform basic actions on their own and make simple decisions by allowing kids to make choices and gain control parents and caregivers help children develop sense of autonomy.
Children who struggle and who are shamed for their accidents may be left without a sense of personal control success during the stage of psychosocial development leads to feeling of autonomy, failure, results, and feelings of shame and doubt
Example  toilet training

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11
Q

 why is the third stage initiative versus guilt, important in the Ericson developmental staging

A

At this point children begin to assert their power and control over the world through direct play and social interactions. Children who successful at this stage, feel capable and able to lead others. Those who fail, acquire the skills are left with a sense of guilt and self doubt, success leads to a sense of purpose.

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12
Q

Why is stage four industry versus inferiority an important stage in Erickson’s developmental staging?

A

Through social interactions, children begins to develop a sense of pride in their accomplishments in abilities, children need to cope with the new social and academic demands. Success leads to a sense of competence will failure, results and feelings of inferiority, those who receive little or no encouragement from parents, teachers or peers will doubt their abilities to be successful.

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13
Q

Define intellectual disability

A

A disorder with onset during the developmental period that includes both intellectual and adaptive functioning deficits, and conceptual, social impractical domains

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14
Q

When does the onset of an intellectual developmental disorder occur

A

Prior to 18 years and is characterized by impairments in measures intellectual performance and adaptive skills across multiple domains

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15
Q

How is the general intellectual functioning measured?

A

Both clinical assessments in a persons performance on an IQ test

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16
Q

What is adaptive functioning?

A

Refers to a persons, ability to adapt to requirements of activities of daily living and expectations of his or her cultural group

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17
Q

What accounts for approximately 30% of intellectual disability cases

A

Conditions that result in early alteration, in embryonic development

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18
Q

The degree of severity of an intellectual disability may be measured by what

A

The clients acute level

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19
Q

How are the levels of an intellectual disability categorized?

A

Mild, moderate severe and profound
The levels are differentiated between the ability of the child to perform self-care, cognitive and educational ability, social and communication capabilities, and psycho, motor capabilities

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20
Q

What does mild intellectual disability look like?

A

Capable of independent, living academic skills to six grade level developing social skills and psycho motor skills, not affected

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21
Q

What does moderate intellectual disability look like?

A

Can perform some activities independently capable of academic skill to second grade experience some limitation and speech and motor development is fair

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22
Q

What does severe intellectual disability look like?

A

Trained in elementary hygiene, skills require supervision. Unable to benefit academically minimal verbal skills poor psycho, motor development, simple tasks.

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23
Q

What is profound, intellectual disability look like?

A

No capacity for independent functioning, constant aid, and supervision Little, if any speech, lack of ability for both fine and gross motor movements

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24
Q

What are some possible nursing diagnosis for intellectual disability?

A

Risk for injury
Self-care deficit
Impaired verbal communication
Impaired social interaction
Delayed growth and development

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25
How would you create a plan of nursing interventions with a child who has an IDD?
 the plan of care directed toward the individual client with the participation of primary caregivers, including the scope of the client condition, realistic expectations, and resources
26
What is autism spectrum disorder characterized by?
Withdrawal of a child into the self, and into a fantasy world that is his or her own creation
27
What are some of the signs of autism
Inappropriate playing with toys Inability to relate to others Hyperactivity or passiveness Inappropriate laughing or crying Over sensitive or sensitive to sounds Poor speech, or lack of speech Strange attachment to objects Lack of awareness of danger Difficulty dealing with changes to a routine
28
How does someone diagnose with autism spectrum disorder?
Diagnosis is adapted to each individual by clinical specifiers level of severity, verbal abilities and associated features known genetic disorders. Autism spectrum disorder includes a wide range of symptoms and levels of severity that impact thinking, feeling communication and social relationships. Behavior is often limited and repetitive, but each child is likely to have unique pattern of behavior and level of severity from low to high functioning
29
Is autism one specific disorder?
No, it occurs along a spectrum, varying levels of functionality. Some individuals are highly functioning and highly intelligent, in spite of communication, impairments and repetitive or restrictive behaviors.
30
What are you assessing for in a child with with autism
Impairment and social interaction Impairment and communication and imaginative activity Restricted activities and interest
31
Why does a child with autism have impairment and social interaction?
Children with ASD have difficulty forming interpersonal relationships with others. They show little interest in people and often do not respond to others attempts at interaction as infants they may have a version to affection and physical contact as toddlers attachment to a significant adult may be either absent, or manifested an exaggerated adherence .
32
Why might a child with autism have impairment in communication and imaginative activity?
Both verbal and nonverbal skills are affected in more severe levels. Language may be totally absent.
33
Why about a child with autism have restricted activities and interest
Even minor changes in the environment are often met with resistance, or sometimes with agitated irritability attachment to or extreme fascination with objects that move or spin is common They may have hand clapping, rocking or swing and repeat words. Diet includes eating specific foods, or consuming a lot of fluids.
34
What are two medication’s that are approved by the FDA to help with autism
Risperidone Aripirprazole Directed toward relief of aggression and self harm, impulsivity intent, tramp terms
35
How would you describe a patient who has ADHD
Highly distractible and unable to contain stimuli motor activity excessive and movements are random and impulsive
36
When is a patient with ADHD usually diagnosed
When they go to school?
37
What is hyperactivity in ADHD?
Excessive psychomotor activity, verbal utterances, that are usually more rapid than normal in attention and distractibility
38
What is impulsiveness in ADHD?
Treat of acting out without reflection, and without thought of the consequences of behavior Abrupt inclination to act in ability to resist acting on a certain behavior
39
What are the categorizations in sub types of ADHD?
Combined type meeting both in attention and hyperactivity/impulsivity Predominantly in attentive present Predominantly hyperactive/impulsive presentation
40
What are you assessing for in a patient who has ADHD
Difficulty performing age appropriate tasks Hi distractibility Extremely limited attention span Impulsivity Difficulty forming satisfactory interpersonal relationships Behaviors that inhibit acceptable social interaction Disruptive Excessive activity fidgeting Accident prone No frustration tolerance and temper outburst
41
What are common coma bid psychiatric disorders that are prevalent with ADHD?
Oppositional, defiant disorder Conduct disorder Anxiety Depress Bipolar Substance use
42
What comorbidities of ADHD can be treated concurrently
Depression and anxiety
43
What comorbidities of ADHD must be treated and stabilized before beginning treatment for ADHD
Bipolar in substance used disorder
44
What are some nursing diagnosis is for ADHD?
Risk for injury Impaired social interaction Low self-esteem due to negative feedback Noncompliance with task expectations
45
Nursing interventions with a child with ADHD
Ensuring client remains free from injury Appropriate interactions with others Increasing self-worth Fostering motivation for compliance with tasks
46
In adolescent diagnosed with ADHD is having difficulty maintaining concentration in the end. Client milieu which nursing intervention would help improve client task performance. Mandate that the client remain in their room until all homework is complete Remove privileges if homework is not completed within a two hour. Period. Encourage dividing tasks into smaller, attainable steps and reward successful completion See order to discontinue the stimulation of methylphenidate Ritalin
Encourage dividing tasks into smaller, attainable steps and reward successful completion
47
What are a psycho pharmacological intervention for ADHD
Stimulants Dextro amphetamine Methamphetamine Methylphenidate
48
 what are some side effects of stimulants used for ADHD
Insomnia Anorexia Weight loss Tachycardia Decrease in rate of growth and development
49
What is the essential feature of Tourette’s disorder?
The presence of multiple motor ticks in one or more vocal tics
50
What are simple motor ticks?
Eye blinking Neck jerking Shoulder. Shrugging Facial, grimacing 
51
What are complex motor ticks
Squatting Hopping Skipping Tapping Retracting steps, 
52
What do vocal tics include
Words, or sounds such as squeaks grunt, sparks sniff, snort, coughs, or uttering obscenities Include repeating certain words, or phrases out of context, repeating one’s own sound, or words, or repeating what other say
53
What is it called when someone repeats their own sounds or words
Palilalia
54
Why do people express ticks?
They are experienced as compulsive and irresistible. Some can be suppressed, but many report buildup tension, and Hass to be expressed against their will.
55
When do ticks worsen?
During periods of stress or excitement, and better during periods of calm
56
What are common medication used for Tourette’s?
HaloPeridol Pimozide Aripiprazole Often not the first line choice of therapy because of severe adverse effects, but highly effective Clonidine Guanfacine (anti-hypertensive ) Have favorable side effects, and effective for coded symptoms of ADHD, anxiety and insomnia
57
What are some non-pharmacological treatments for just Tourette’s?
CBIT Speech therapies Deep brain simulation ( last resort) Pharmacological therapy is most effective when combined with psychosocial therapy
58
What is CBIT?
Reduces the severity of ticks by teaching how to recognize in manage environmental triggers
59
What is oppositional, defiant disorder, characteristic by?
Persistent pattern of angry mood and defiant behavior that occurs more frequently than is usually observed in individuals of comparable, age in development level, and interferes with social education or vocational activities
60
When does oppositional defiant disorder usually occur?
Typically begins around age is 10 or 11 months and usually no later than adolescence
61
What is the family influences on a child with oppositional defiant disorder?
If power and control are issues for parents, or if they exercise authority for their own needs, a power, struggle can be established between the parent and the child which such the stage for the development of ODD
62
What are some characteristics of a child with ODD?
Stubbornness procrastination Disobedience negativism Carelessness testing limits Resistance to directions Unwillingness to cooperate Running away School, avoidance, and under achievement Temper tantrums, fighting, argumentativeness 
63
Do children with ODD think it’s their fault
They usually do not see themselves as being oppositional view. The problem is arising from other people that they believe are making unreasonable demands. Perceive human relationships as negative and unsatisfactory
64
What is conduct disorder?
Repetitive and persistent pattern of behavior in which the basic rights of others or societal norms or rules are violated Physical aggression is common
65
What is one of the most frequent reasons child and adolescence are referred for psychiatric intervention
Conduct disorder
66
What is a comorbidity of conduct disorder Ord
ADHD mood disorders, learning disorder, substance used disorders Can lead to antisocial personality disorder
67
How does the family influence conduct disorder?
Poor academic performance and social male adaptation can lead to affiliations with deviant peer groups There can be ineffective parenting Inconsistent management with harsh discipline Parental sociopath Lack of parental supervision Frequent changes in residence Marital conflict
68
What should you be assessing in a patient who has conduct disorder
Yusuf physical aggression in the violations of rights of others Stealing lying truancy Use of non-prescribed drugs, alcohol to tobacco Sexual permissiveness Tough guy act Inability control,anger Lower academic achievement Lack of feeling guilt
69
Conduct disorder may be a precursor to the diagnosis of which personality disorder Narcissistic personality disorder Antisocial, personality disorder Histrionic, personality disorder Passive aggressive, personality disorder
Antisocial, personality disorder
70
How can behavioral therapy help in conduct disorder ADHD or ODD
They are disruptive behavior disorders with this approach rewards are given for appropriate behaviors and withheld behaviors are disruptive or otherwise inappropriate
71
Why is family therapy important for children and adolescence?
Must involve entire family. If treatment is to be successful parent should be involved in designing and implementing the treatment plan for the child and should be involved in all aspects of the treatment process.
72
Which of the following groups is most commonly used for drug management of a child with attention deficit hyperactive disorder CNS depressants diazepam Valium CNS stimulants methylphenidate Ritalin Anti-convulsants phenytoin Major tranquilizers, haloperidol
Sienna stimulants, methylphenidate Ritalin
73
The nursing history and assessment of an adolescent with conduct disorder might reveal all the following behaviors, except Manipulation of others for fulfillment of own desires Chronic violation of rules Feeling of guilt associated with exploitation of others In ability to form peer relationships
Feeling of guilt associated with the exploitation of others
74
Certain family dynamics, often predisposed adolescence to the development of conduct disorder, which of the following patterns is thought to be contributed factor Parents who are overprotective Parents who have high expectations for their children Parents who consistently set limits on their children’s behavior Parents who are alcohol dependent
Parents who are alcohol dependent
75
Which of the following is least likely to predispose a child to Tourette’s disorder Absent of parental bonding Family history of disorder Abnormalities of brain transmitters Structural abnormalities of the brain
Absent parental bonding
76
Which of the following medication is used to treat Tourette’s disorder Methylphenidate Ritalin Haloperidol (Halfol) Imipramine Phenytoin
Haloperidol
77
The child with attention deficit hyperactive disorder has a nursing diagnosis of impaired social interaction which of the following nursing interventions are appropriate for the child select Socially isolate, the child with interactions with others are inappropriate Set limits with consequences on inappropriate behaviors Provide rewards for appropriate behaviors Provide group situations for the child
Set limits with consequences on inappropriate behaviors Provide rewards for appropriate behaviors Provide group situations for the child
78
To help a child with mild to moderate intellectual development disorder, develop satisfying relationships with others, which of the following nursing interventions is most appropriate Interpret the child’s behavior for others Set limits on behavior that is socially inappropriate Allow the child to behave spontaneously because he or she has no concept of right or wrong This child is not capable of forming social relationships
Set limits on behavior that is socially inappropriate
79
The child with autism spectrum disorder has difficulty with trust with this in mind, which of the following nursing actions would be most appropriate Encourage all staff to hold the child as often as possible conveying trust through touch Assign a different staff member each day so the child will learn that everyone can be trusted Assign the same staff person, as often as possible to promote a feeling of security and trust Avoid I can’t text because it is extremely uncomfortable for the child and may even discourage trust
Assigned the same staff person as often as possible to promote feelings of security and trust
80
Which of the following nursing diagnosis would be considered the priority and planning care for a child with severe autism spectrum disorder? Risk for self mutilation evidence by banging head against wall Impaired social interaction evidence by unresponsiveness to people Impaired verbal communication evidence by absence of verbal express Disturbed personal identity, evidence by inability to differentiate self from others
Risk for self mutilation evidence by banging head against wall
81
A child with ADHD is admitted to a residential treatment program which of the following group activities would be the most appropriate for the nurse to recommend Monopoly Volleyball Pool Checkers
Volleyball

Psych (13 decks)

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