What are the characteristics of a healthy family?
- Have clear Boundaries - Individuation (Each member can be themselves) - Self-Disclosure (Can express feelings freely) - Intimacy exists / Deep Feelings - Predictability - Emotionally Available
What are some risk factors for families to become dysfunctional?
- Unresolved Marital/Partner Issues
- Unresolved Sibling Conflict
- Life Stressors (Nsg dx: Ineffective family processes) Inadequate support, food, resources etc
When do we diagnose mental disorders in children?
When it interferes with normal function
What is the most important intervention for families or children with disorders?
Look at the entire group not just one specific person
Define group as a whole
Never take a person to the side and NEVER point out a sick person
What communication/function do they have in severe mental retardation?
Minimal communication and can learn some basic skills
What communication/function do they have in profound mental retardation?
Very low functioning
May not speak
Kind of like an Infant
What are some causes of mental retardation?
-Heredity (Tasacs, XSyndrome, Lower IQ)
-Pregnancy (Illness during)
-Medical Condition (High fever, certain illnesses)
-Environmental Influences (Not so much now; lead poisoning)
What does SAFETY stand for with Mental Retardation?
S - Abuse, Cognitive function, Psychosocial history
A - Make sure you pay attention to all orders
E - Evaluate Pharmacology
T - Teach
Y - Documentation!!!
What is the main difference between Autistic and Asperger disorders?
Communication and IQ
What are some assessments for Autistic?
- Severe impairment to social interaction
- Communication skills are lacking
- Lack of spontaneous enjoyment
What are some assessments for Aspergers?
- Normal IQ's
- Good verbal communication but socially awkward
For pervasive developmental disorders (autistic and aspergers) what are some common nursing dx?
- Risk for social isolation -
Risk for impaired family communication
- Altered Sensory Perception
What is a goal for PDD?
Increase social interaction
What is an intervention for PDD?
Consistency with staff
Is there any pharmaceuticals to treat PDD?
No - just treat underlying symptoms
What are some assessments for tourettes?
- Motor tics
- Vocal tics
- Coprolalia (uttering of dirty words)
What are some interventions/treatments for tourettes?
Tenex (Curbs anxiety)
What is the incontinent of bowels with children who have been bowel trained?
What is the incontinence of the bladder?
What are some factors for separation anxiety disorder?
- Only dx when leads to dysfunction
- Usually do not give anti-anxiety meds
- Use anti-depressants or BUSPAR
- Assess level of anxiety, what level of functioning, ill effects
When does reactive attachment disorder occur?
When children have a separation or trauma
They have no personal ties (What can you do for me)
What is selective mutism?
Choose not to talk
Ususally caused by trauma
What are some assessments for ADHD?
• Misses Details
• Has difficulty sustaining attention
• Easily Distracted
• Talks excessively
• Can’t wait turns
What are some assessments for ODD?
• Hostile Behavior towards Adults
• Significant impairment in social and academic functioning
What are some assessments for CDD?
• Aggression towards people and animals
• Destruction of Property
• Deceitfulness, “con artist” behavior
• Serious violations of rules and run ins with the law enforcement
• No empathy for others - They have no regard for rules or people
What are some interventions for ADHD, ODD, CD?
- Decrease Stimuli
- Give Choices
- Remove from environment
- Firm limits
What is some pharmacology for ADHD?
Straterra (SNRI antideppressant)
What are some side effects of ADHD meds?
Sleep and Nutrition are BIGGEST!!!!
Due to growth and development
Dry mouth, tachycardia, insomnia and dec apetite
What kind of meds would you give for CD?