Psychiatric Care: Child & Adolescent Flashcards Preview

N420 Flashcards > Psychiatric Care: Child & Adolescent > Flashcards

Flashcards in Psychiatric Care: Child & Adolescent Deck (21):
1

Risks factors contributing to child/adolescent disorders: psychosocial

Developmental trauma especially early or during adolescence (sexual/physical/emotional)
Unclear expectations (explosive/angry parents)

2

Risk factors contributing to child/adolescent disorders: social/environmental

Severe marital discord, low SES, overcrowding, parental criminal activity, maternal MI, any abuse

3

Risks factors contributing to child/adolescent disorders: cultural/ethnic

Culture shock, assimilation trauma especially from oppressed, impoverished minority

4

Other risk factors contributing to child/adolescent disorders

Temperament, biochemical, genetic, prenatal/postnatal issues

5

Anxiety disorders in kids: Increasing rapidly
Correlates with decreases in social connectedness

Increased divorce rate, more people living away from larger family. Also connected to violent crime, worry about war, fear of disease, more women in the workplace, multitude of choices to make

6

Normal kids ______ have problems.
Big range of what constitutes normal. ______ are needed for growth. Eriksonian stages for emotional development. Physical issues like hormone surges, growth spurts, nutrition, etc.

Normally

Stress>>>"Reasonable regression"?

7

Anxiety Disorders
1. Separation anxiety opposite of "_______ disorder"
2. Post-trauma disorders
3. Sx similar to adult anxiety disorders. May be temporary if treated well, but can progress into ______ disorders or other long-term anxiety disorders.

Attachment

Panic

Big challenge to correctly diagnose and treat correctly

8

Major Depression/Suicidality
______ than adult depression.
More _______ loss.
More irritable, acting out behaviors.
More withdrawal, preoccupation with hurting or killing self.
Often very somatic - cutting behaviors.

Different

Self-Esteem

9

Up to _____% of teens have thought about suicide and it is 2nd cause of death in teens. Biggest risks are ______ peer suicide, ______ y/o WM, ______ Hx, previous attempt, ______ available, ______ (real or perceived)

25%
Recent
15-19
Family
Gun
Loss

10

Nursing Care for Depressed Kids
Watch for ______ changes. Don't be fooled if depressed kid is suddenly "just fine" SAFETY. "No suicide contracts" Open communication. Antidepressants/Mood stabilizers are best when combined with ______ therapy.

Sudden

Talk

11

PDD (Pervasive Developmental Disorders) are neuro-psych disorders, behavior problems associated with abnormal ______ function.

Brain

12

Autism is often with mental ______. M>F usually before ______ years old. Little _______, communication and language delays, stereotyped movements, rituals, self-stimulation that are ______ to interrupt.

Retardation
Three
Socialization
Catastrophic
(MIND institute, support groups, behavior modification, physical and occupational therapies, meds - Focus is on SAFETY, communication)

13

Asperger's disorder has a _____ onset, no ______ in cognitive or language development, restrictive/repetitive patterns of behavior, ______ interests, social ______, empathy

Later
Delay
Idiosyncratic (odd)
Impairment

14

Disruptive Disorders: ADD & ADHD
Usually have other disorders too. ADD, _ _ _, and ______ disorder commonly seen with them, and Tourette's and/or ______ abuse. Often seem distractible, impulsive, hyperfocus or no focus, high risk for injury.

OCD
Mood
Substance

15

Nursing Management of ADD, ADHD
Thorough ______ ______ and physical exams, ensure safety, KISS, set ______ of acceptable behaviors, Behavior mod (get their full attention, structure routines, decrease stimuli), Break up tasks into small steps, avoid _______ struggles, teach family what works and what doesn't, refer to support groups, diet, exercise (outside, big muscles), meds

Mental Status

Limits

Power

16

Management of ADHD works best with ______ and ______ together.

Medications: psychostimulants - help increase concentration/attention - Ritalin, caffeine, others. (SE weight loss, tics, insomnia, depression, aggression, others)
Therapy: behavior modification, consistency/routine, focusing, rewards for appropriate behavior.

17

Other meds for ADHD include a non controlled substance _______ which is a NE reuptake inhibitor. Also clonidine, atenolol, antidepressants can be used.

Strattera

18

Oppositional Defiant Disorder and Conduct Disorder may include ______ activities, ______ property, ______ others. Solitary or individual activities, takes months or years of therapy work. May be some form of ______ (similar Sx).

Criminal, Destroying, Hurting, Depression
(Consistency, limits, encourage open communication of feelings/verbalizing anger rather than acting on it, deliberately ignoring, choosing your battles, humor, etc)(Meds may include mood stabilizers, lithium, beta blockers)

19

Progressive Limit Setting & Time Outs
Establish clear ______.
______ the problem behavior (Specific).
State the ______ (Get them involved?).
Inform of acceptable ______.
One warning? 1...2...3...Time-Out, Follow up and discuss, CONSISTENCY.

Rules
Label
Consequences
Behavior

20

Substance Abuse risk factors in kids include

F>M
High Stress
Boredom
Disposable income, increased risk as $ increases
Access to prescribed medication

21

General nursing interventions when kids have psych disorders

Check your feelings
Communicate clearly and genuinely
Role-model, don't imitate
Respect their space
Don't force, Use silence
Appropriately praise and reward desired behaviors
Use humor PRN
Work with their strengths
Accept the person, can dislike the behavior
Assertiveness training
Teach family
Internet resources