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PSYCH > TOPIC 9 - neurodevelopment & neurocognitive disorders > Flashcards

TOPIC 9 - neurodevelopment & neurocognitive disorders Flashcards

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1
Q

factors related to childhood neurodevelopment disorders

A

genetics
biochemistry : a genetic imbalance in a nutrient needed for NT synthesis can result in brain chemistry problems
environment : abuse or neglect impacts wellbeing

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2
Q

developmental milestones

A

Crawling
Walking
Fine motor skills
Physical skills
Problem-solving
Socialization
Language & communication

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3
Q

what is the result of delayed socialization and communication skill development

A

isolation

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4
Q

deficit in social reciprocity

A

trouble with how the child responds or reciprocates when socially interactive

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5
Q

deficit in joint attention

A

trouble with wanting to share an interest

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6
Q

deficit in nonverbal communication

A

trouble with ability to use or interpret nonverbal cues

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7
Q

deficit in social relationships

A

trouble making and maintaining relationships

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8
Q

which approach is most effective for autism

A

interdisciplinary treatment using family centered practice and the use of the community collaboration model

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9
Q

ASD severity level 1

A

speaks in full sentences, difficulty with conversations

difficulty changing activities, difficulty with organization and planning

minimal support needed

can be managed in classroom

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10
Q

ASD severity level 2

A

notable deficit in verbal and nonverbal social communication

does not initiate social interactions

repetitive behaviors are observable

change in routine leads to distress

moderate support needed

may require specialized classroom

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11
Q

ASD severity level 3

A

few spoken words

rarely interacts with others

very resistant to change

need for repetition interferes with daily life

substantial support needed

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12
Q

goal of family centered practice

A

create a partnership so that the family fully participates in all aspects of the individual’s care

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13
Q

interdisciplinary treatment

A

behavior management therapy
cognitive therapy
family centered care
community collaboration model

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14
Q

medications for ASD

A

atypical antipsychotics used for reducing aggressive and or self harm behaviors
SSRI’s and beta blockers for obsessions and anxiety

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15
Q

most effective atypical antipsychotic

A

risperidone

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16
Q

categories of ADHD

A

inattentive, hyperactive/impulsive, combined

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17
Q

diagnostic method for ADHD

A

Vanderbilt Assessment Scale

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18
Q

problem areas with ADHD

A

concentrating, focusing, inattentiveness, not listening, lack of follow through, organization, time management, forgetfulness

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19
Q

school observations in children with ADHD

A

fidgeting in seat, inappropriately running or climbing, blurt out answers, interrupt or talk excessively, inconsistent or messy assignments

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20
Q

interdisciplinary treatments for ADHD

A

Behavioral Modification/Behavioral Therapy
Parent Training
School Accommodations

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21
Q

medications for ADHD

A

Increase frontal lobe activity in the brain
Increase attention span
Decrease impulsive behavior, restlessness & hyperactivity
CNS stimulant medications
Non-stimulant medications

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22
Q

stimulant medications

A

highly effective treatments that have been safely used for decades.
EX : methylphenidate, amphetamines, dexmethylphenidate, lisdexamfetamine

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23
Q

non stimulant medications

A

EX : atomoxetine, guanfacine, clonidine
alternatives for those who do not respond well to stimulants or if a non-stimulant is preferred.

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24
Q

when to give methylphenidate

A

6-8 hours before bedtime

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25
what to monitor with methylphenidate
insomnia
26
when to give methylphenidate ER
12 hours prior to bedtime
27
what to monitor with atomoxetine
can stunt growth (monitor height and weight)
28
primary encopresis disorder
the person have had continuous soiling throughout their lives, without any period in which they were successfully toilet trained
29
secondary encopresis disorder
may develop after toilet training has occurred usually due to encountering stressful experiences such as upon entering school or encountering other experiences that might be stressful
30
retentive encopresis disorder
overflow incontinence due to constipation. If not treated, serious complications such as megalocolon can occur, which may affect colon peristalsis
31
nonretentive encopresis
refers to soiling without evidence of fecal constipation and retention. This form of encopresis  is characteristics include fecal incontinence accompanied by daily bowel movements that are normal in size and consistency
32
enuresis symptoms are normal up to what age
5
33
encopresis symptoms are normal up to what age
4
34
enuresis definition
repeated urinary incontinence Involuntary or intentional voiding in clothing, bed, etc. Nocturnal, diurnal, or both
35
encopresis definition
repeated incontinence of feces into inappropriate places Involuntary or intentional voiding (places may include clothing, on floors, in waste receptacles, etc.) Primary, secondary, retentive, and nonretentive types
36
assessment of elimination disorders
distended abdomen poor appetite incontinent episodes past expected toilet training age
37
interventions for elimination disorders
Parent education Toileting schedules (even during the night for enuresis) Specialist referrals if needed Behavior training / therapies Medication
38
medications for enuresis
imipramine desmopressin oxybutynin indomethacin SSRIs
39
interventions for enuresis
parent education toileting schedule limit fluids before bed positive reinforcement bell and pad methods bladder training school EP
40
interventions for encopresis
parent education referral to gastroenterologist increase dietary fiber and fluid toileting schedule enhanced toilet accessibility CBT Meds : suppository, enema, laxative
41
structural changes to functional areas of the brain in dementia
atrophy ventricle enlargement plaques tangles damaged brain cells neurodegeneration
42
what must you rule out or treat first before dementia diagnosis
medical conditions substance use / abuse cumulative anticholinergic drug effects
43
diagnostic assessments for dementia
electroencephalography (EEG) neuroimaging (MRI, CT) laboratory testing MMSE, mini-cog, mental status exams
44
DSM5 diagnostic criteria for mild cognitive impairment
Cognitive decline from a previous level of functioning in one or more cognitive domains. Major symptom: Memory impairment Excludes people with dementia or age-related memory impairment Cognitive impairment do not interfere with independent day-to-day activities, and socialization
45
path to diagnosing mild cognitive impairment
Standardized neuropsychological test indicate modest impairment. Mental status exam Reports from family, friends, or clinicians
46
MCI assessment
Forgetfulness- important events or appointments Difficulty following conversations Difficulty following a plot in books or movies Have trouble navigating familiar places Becomes overwhelmed by previously easy task Require greater effort and time to perform task (use to be performed effortlessly)
47
defense mechanisms of MCI
Denial- hiding memory deficits Confabulation- making-up stories or answers to maintain self esteem when something is forgotten Perseveration- repetition of phrases or behavior Avoidance- avoid answering questions
48
primary dementia
Irreversible Progressive (four stages) Not secondary to any other disease process Example: Alzheimer’s disease (AD)
49
secondary dementia
Result of some other pathologic process Example: Acquired immunodeficiency syndrome (AIDS)/HIV, (older adults remain sexually active), vascular dementia, Pick’s disease, Huntington's disease Depression often mimics signs/symptoms of dementia
50
when you see fluctuating levels of alertness what should you suspect
delirium NOT dementia
51
risk factors for alzheimers
Age and gender: (Affects women more than men) Incidence doubles after age 65 Older African Americans (twice as likely to develop AD) Hispanic Americans (1.5 times more likely)
52
prodromal phase of alzheimers disease
brain changes occur 10-20 years prior to symptoms
53
4 A's
Amnesia - Amnesia/memory impairment Aphasia - Initially has difficulty finding correct word, then only uses a few words, finally babbling or mutism Apraxia - Loss of purposeful movement (e.g.,walking, dressing self) Agnosia - Loss of ability to recognize sounds (auditory agnosia), recognize objects (visual or tactile agnosia)
54
stage 1 of alzheimers disease
Short-term memory loss: loses things, forgets things Difficulty learning new things Occupational abilities may be intact, often able to work Behavioral problems: depression, apathy Impaired activities: grocery shopping, managing finances
55
stage 2 of alzheimers disease
memory gaps related to persons history obvious ADL deficits labile mood, paranoia, anger, aggression, jealousy altered sleep pattern driving hazard around the clock care and supervision needed activity and social withdrawl defense mechanism : denial
56
stage 3 of alzheimers disease (severe)
Severe agnosia: unable to identify people (spouse, family members, friends) Advanced apraxia: requires repeated instructions for simple tasks Severe memory loss (e.g., location of toilet, leads to incontinence) Behavior/mood: agitation, violence, paranoia, and delusions, wandering Institutionalization may be necessary due to : Wandering Danger to self or others Incontinence Behavior affect the sleep and general health of others Total dependence on others for ADLs
57
stage 4 (final stage)
agraphia : may lose ability to read and write hyperorality : a need to taste or chew, puts everything in mouth hypermetamorphosis : a need to touch everything severe apraxia : lose ability to walk dysphagia : difficulty swallowing aphasia : inability to speak seizures weight loss insomnia stupor coma death
58
dementia interventions
always introduce yourself and refer to client by name speak slowly use short, simple words and phrases maintain 1 or 2 arms distance if delusional : acknowledge feelings and reinforce reality if verbally aggressive : acknowledge feelings and change topics
59
health maintenance with dementia
Encourage client participation with care Allow client to preform all task within his/her capabilities Always allow client to wear their own clothing Use clothing with elastic, and replace buttons and zipper with Velcro Give step-by-step instructions (allow time to perform task) If resistive to care, return at a later time
60
nutrition for dementia
Monitor food and fluid intake Offer finger foods Weigh once a week During period of Hyperorality: watch for client eating non food items (i.e. artificial fruits, soaps)
61
elimination interventions for dementia
Implement bowel and bladder training program Use incontinent supplies (e.g., pads or briefs)
62
sleep interventions for dementia
Keep room lights on Keep room clutter free Maintain calm environment throughout the day
63
home safety for dementia patients
gradually restrict driving remove throw rugs minimize sensory stimulation label rooms install safety bars in bathroom
64
interventions for wandering clients with dementia
Place mattress on the floor at night Have client wear a medic alert and provide local police with a recent picture Use complex locks, place locks at top of doors
65
major neurotransmitters involved in alzheimers
acetylcholine and glutamate
66
cholinesterase inhibitors : slows progression in mild to moderate stages
donepezil (Aricept) rivastigmine (Exelon) galantamine(Razadyne)
67
NMDA receptor antagonist : slow progression in moderate to severe stages
memantine
68
combination drugs : for moderate to severe stages
Namzaric (memantine hydrochloride extended-release (ER) combined with donepezil
69
drugs to treat co occurring depressive disorders
SSRIs - lower side effect, ordered for depression mirtazapine (Remeron), side effects of weight gain and sedation are often beneficial
70
non pharm treatment
CBT maintain comfort levels behavioral interventions physical exercise picture magazines compensatory memory aids reality orientation reminiscence/memory therapy simple group activity

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