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PMHNP License > disorders of childhood and adolescence > Flashcards

disorders of childhood and adolescence Flashcards

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1
Q

Assessment care planning pearls for children and adolescents

A

takes more time

develop trusting relationship

interview child (internal) and parent separately (external)

must focus on developmental needs and interest of the child

must focus on cognitive and language abilities of the child

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2
Q

MSE differences for child/adolescent

A

modified to reflect developmental and other age related issues

odften requires play environment to open communication

Appearance: conclusions must consider age/dev (physical appearance/dress), and gait/motor skills (for age)

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3
Q

Assessment care planning for children and adolescents

parent/child interaction

A

observe in waiting room

examine how they talk to each other and emotional overtones

separation/reunion assess

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4
Q

Assessment care planning pearls for children and adolescents

speech/language

A

expected normative and appropriate use for age

comprehension/word selection/range of vocab

rate/rhythm/latence/intonation/spontaneity

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5
Q

Assessment care planning pearls for children and adolescents

mood/affect

A

Mood: verbal admission of feelings/assessment based on themes, play, Fantasy

Affect: range of emotions expressed, appropriateness of affect to thought content

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6
Q

Assessment care planning pearls for children and adolescents

Thought process and content

A

Thought process: loose associations, magical, thinking, preservation, echolalia, distinguished fantasy from reality (4), flight of ideas

Thought content: SI/HI, hallucinations

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7
Q

Assessment care planning pearls for children and adolescents

social relatedness

motor behavior

cognition

memory

A

Social relatedness: child response to interview interviewer

Motor behavior: coordination, activity, involuntary movement, tremor, tick, unusual asymmetry

Cognition: intellectual functioning, problem-solving abilities

Memory: test recall after five minutes (school age)

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8
Q

Assessment care planning pearls for children and adolescents

abstraction

A

Expected normative behavior for age

12 or younger should have abstract thought abilities (younger have concrete thinking)

Proverb testing require prior exposure to concept

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9
Q

Assessment care planning pearls for children and adolescents

Judgment and insight

A

Child’s view of problem

Child’s understanding of what he or she can do to help the problem

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10
Q

Assessment care planning pearls for children and adolescents

Therapeutic care planning

A

Variety of effective treatments commonly used with children and adolescence

Play therapy
Art therapy
Bibliotherapy
Orative therapy
Behavioral therapy
Interpersonal therapy
Cognitive therapy
Milieu therapy?
Pharmacotherapy

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11
Q

ODD

A

An enduring pattern of angry/irritable mood and argumentative, defiant, or vindictive behavior

6+ mo with 4+:

Loses temper
Touchy/easily annoyed
Angry/resentful
Argues with authority
Actively defies/refuses to comply with authority
Blame others
Deliberately annoys others
Spiteful/vindictive

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12
Q

ODD etiology

A

Temperament
extreme emo parents
trauma
unresolved conflict

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13
Q

ODD MSE

A

Mood: lability: low frustration tolerance, angry, argue/lost temper

Concentration: impaired

Thought content: often blames others for mistakes

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14
Q

ODD mgmt

A

Pharma is not 1st line

target sx: mood/aggression

Therapy is mainstay
–individual, family
–child/parent problem solving skills training (Incredible Years, Parent-child interactional therapy, ATP)

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15
Q

Conduct Disorder

A

Repetitive and persistent pattern of behavior in which the rights of others or societal, norms, or rules are violated

3+ criteria in the last 12 mo with 1 in the past 6 mo:
Aggression toward people or animals
Destruction of property
Deceit or theft
Serious violation of rules
Child onset before 10 or adolescent onset after 10

Can be 18 or older if criteria for antisocial personality disorder, not met

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16
Q

CD MSE

A

Affect is irritable, angry, uncooperative

Mood is anger

The content is lack of empathy

Concentration is distractible

Insight is poor

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17
Q

CD mgmt

A

No specific Pharma

Aggression/agitation treatment with multiple types of medication

Multi modality, treatment programs that incorporate, family, and community resources

Behavioral therapy is a main stay

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18
Q

ADHD

A

Persistent pattern of attention or hyperactivity, impulsivity, or both that interferes with functioning and development

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19
Q

ADHD and attention 6+

A

Fails to give attention to details
Difficulty sustaining attention
Does not listen when spoken to
Does not follow through instructions
Disorganized
Avoids or dislikes tasks with sustained effort
Loses things
Distracted
Forgetful

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20
Q

ADHD and hyperactive/impulsive 6+

Study These Flashcards
A

Fidgets
Leaves seat
Runs or climbs
Unable to engage in quiet activities
On the go
Talk excessively
Blurt out information
Difficulty waiting turn
Interrupts others

21
Q

ADHD subtypes

Study These Flashcards
A

Inattentive type
–inattentive symptoms dominate
–lack criteria for hyperactivity impulsivity

Hyperactive type
–hyperactivity/impulsivity dominate
–lack criteria for inattention

Combined type
–symptoms met for both

22
Q

polygenic neurobiological deficits associated with ADHD

Study These Flashcards
A

Problems with executive function

Abnormality of fronto-subcortical pathways

Abnormality of reticular activating system

structural abnormalities producing NT abnormalities (DA and NE)

23
Q

percentage of ADHD clients that have symptoms persisting into adulthood

24
Q

ADHD, average age of onset

25
ADHD mean age of diagnosis
Nine years
26
stimulant medication side effects
G.I. Cramps Anorexia weight loss Blood pressure changes Increased pulse Growth suppression (rare) Headache/dizzy Irritability Psychosis (rare)
27
ADHD standardized
Connor's parent and teacher rating scale Vanderbilt
28
ASD
Persistent deficits in social communication and social interaction across multiple settings --associated with deficits in social reciprocity, nonverbal communication, developing/maintaining/understanding relationships Restricted repetitive behavior --stereotype or repetitive motor movements --insistence on sameness --highly restricted with fixed interest --hyper or hypo sensory input
29
ASD assessment hx
social impairment, including peer relationships, and emotional reciprocity, and spontaneous seeking of enjoyment Impaired communication Restricted/repetitive/stereotype patterns of behavior/interest/activities. Note inflexible. Parents may report many sx
30
parents of poss ASD child may report
language delay, including no cooing by age 1, no word by 16 months, no two word phrase by 2 Loss of language skill at any time No imaginary play Little interest in playing with other children Extremely short attention, man No response when called by name Little or no eye contact Intense tantrums Fixation on single objects Unusually strong resistance to change in routine Over sensitivity to sounds, etc. Appetite or sleep, rest disturbance Self injurious behavior
31
ASD screening
M-CHAT ADOS ASQ
32
ASD DD
Rett Asperger Childhood disintegrative disorder intellectual disability hearing impairment developmental language/speech tic disorders stereotypic movement disorder schizophrenia cluster A personality disorders
33
ASD mgmt
no specific pharma antipsych for tantrum/aggression/self injury/hyperactive/repetitive -multiple other options including antidepressants, naltrexone, clonidine and stimulants to diminish self injury/hyperactive/obsessive behavior Behavioral therapy Occupational therapy Speech therapy Pivotal response training Appropriate school placement
34
Rett Syndrome
Development of specific deficits following a period of normal functioning after birth
35
Rett syndrome hx
Normal prenatal and perinatal Normal cycle motor development through five months Normal head circumference of birth Onset of deceleration of head growth 5-48 mo Also previously acquired purposeful hand skills 5-30 mo Early loss of social engagement Appearance of poorly coordinated gait Severely impaired expressive and receptive language
36
Rett physical exam findings
Associated features: Seizures Irregular respirations Scoliosis Loss of purpose for hand skills Stereotypic hand movements
37
eating disorders
Characterized by disordered patterns of eating, accompanied by distress, disparagement, preoccupation, and a distorted perception of one's body shape
38
common forms of eating disorders
Anorexia nervosa --refuses to maintain normal body weight --restricted calorie intake --intense, fear gain weight Bulimia nervosa --binging combined with inappropriate ways of stopping weight gain --associated with efforts made to lose weight --usually normal/slightly overweight binge eating disorder --recurrent episodes of binge eating with lack of control --at least two days a week for six months --not associated with compensatory behaviors
39
anorexia nervosa assessment
Refusal to maintain a minimally, normal body weight Weight less than 85% of expected weight Fear of gaining weight or becoming fat Distorted body image -restricting type: not regularly engaged in binging/purging -binge eating or purging type: regularly engaged in binge/purge
40
Bulimia nervosa assessment
Recurrent/episodic binge eating Both binging and inappropriate compensatory behaviors at least twice weekly for three months Recurrent/inappropriate compensatory behaviors to prevent weight gain --self induced vomiting --laxatives --enemas --diuretics --stimulants --abusive diet pill pills --fasting --excessive exercise Self evaluation, unduly, influenced by body shape and weight --purging type --Non-purging type
41
FDA approved for bulimia nervosa
Fluoxetine
42
medication effective in reducing the frequency of binging and purging
SSRI and TCAs
43
non-pharmacological treatment for eating disorders
Medical and nutritional stabilization Dental care Psychotherapeutic interventions Community resources
44
intellectual disability
Onset during the developmental period and includes low intellect and adaptive functioning Onset before 18 Mild/moderate/severe/profound --based on adaptive functioning and not IQ --IQ is less valid on the lower end of IQ range
45
intellectual disability etiology by percent
Heredity is 5% Early altered embryo development is 30% Pregnancy/perinatal problems is 10% General medical conditions required during infancy/childhood is 5% No etiology is 30 to 50% most preventable is fetal alcohol
46
fetal alcohol syndrome, characteristics
epicanthal skinfolds Low nasal bridge Short nose Indistinct philtrum Small head circumference Small eye openings Wide set eyes Thin upper lip
47
DMDD
Disruptive mood dysregulation disorder childhood depressive disorder that is diagnosed in children, older than six but younger than 18 Features are chronic regulated mood, frequent temper, outbursts, severe irritability
48
DMDD assessment
Assess for comorbid, bipolar, ODD, ADHD, depression, anxiety, ASD
49
DMDD MGMT
Medication to target symptoms Therapy

PMHNP License (17 decks)

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