Flashcards in Psychiatric Care: Child & Adolescent Deck (21):
Risks factors contributing to child/adolescent disorders: psychosocial
Developmental trauma especially early or during adolescence (sexual/physical/emotional)
Unclear expectations (explosive/angry parents)
Risk factors contributing to child/adolescent disorders: social/environmental
Severe marital discord, low SES, overcrowding, parental criminal activity, maternal MI, any abuse
Risks factors contributing to child/adolescent disorders: cultural/ethnic
Culture shock, assimilation trauma especially from oppressed, impoverished minority
Other risk factors contributing to child/adolescent disorders
Temperament, biochemical, genetic, prenatal/postnatal issues
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
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.
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.
Big challenge to correctly diagnose and treat correctly
______ than adult depression.
More _______ loss.
More irritable, acting out behaviors.
More withdrawal, preoccupation with hurting or killing self.
Often very somatic - cutting behaviors.
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)
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.
PDD (Pervasive Developmental Disorders) are neuro-psych disorders, behavior problems associated with abnormal ______ function.
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.
(MIND institute, support groups, behavior modification, physical and occupational therapies, meds - Focus is on SAFETY, communication)
Asperger's disorder has a _____ onset, no ______ in cognitive or language development, restrictive/repetitive patterns of behavior, ______ interests, social ______, empathy
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.
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
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.
Other meds for ADHD include a non controlled substance _______ which is a NE reuptake inhibitor. Also clonidine, atenolol, antidepressants can be used.
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)
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.
Substance Abuse risk factors in kids include
Disposable income, increased risk as $ increases
Access to prescribed medication