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72 Cards in this Set

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Most common childhood psychiatric disorders
- pervasive disorders
- ADHD
- Disruptive disorders
Mental retardation ranges
- 50-70 = mild
- 35-50 = moderate
- 20-35 = severe
- below 20 = profound
% children with learning disorder
5%
Motor skills disorder often coexists with _______ _______
communication disorders
Treatment for motor skills disorder
tx w/ sensory integration programs
Tx for communication disorders
Speech therapy
Pervasive developmental disorders
- autism
- childhood disintegrative disorder
- asperger's disorder
Aspergers disorder
Similar to autism but without language problem
Rett's disorder
rare - girls only - 0-5 mos - occurs after normal period of function - tx similar to autism
Autism
little eye contact and few facial experssions, hand flapping, body twisting, head banging, doesn't relate to peers
Meds for autism
used to treat sx, not disorder
- Antipsychotics; ReVia, Anafranil, Catabres, stimulants
goals in autism tx
reduce behavioral sx and promote learning, development, and language skills
Meds for ADHD
stimulants: Ritalin, Adderall, Dexedrine, Cylert
--- antidepressants (eg. strattera, an SSRI) are 2nd choice.
Activity peaks (pattern for manic vs. ADHD patient)
manic patient has 1 peak of activity/day
ADHD pt has 2 peaks/day
Important risk factor in conduct behavior
child abuse
Difference between conduct disorder and Oppositional Defiant Disorder
Opp/Def feel bad and are aware of the effect of their behaviors on others
Med tx for tic disorders
treated w/ atypical antipsychotics such as olanzapine or risperidone
coprolalia
use of socially unacceptable words; frequently obscene
palilalia
repeating of ones own sounds or sords
echolalia
repeating the last-heard sound, word, or phrase
transient tic disorder
single or multiple vocal and/or motor tics, but does not last longer than 12 mos
encopresis
defecating in inappropriate places by a child of at least 4 years
enuresis
repeated urination during day or night in clothes or bed after age 5
Tx for separation anxiety disorder
behavior mod activities -- parent education and family therapy are essential
Reactive Attachment disorder
markedly distrubed and developmentally inappropriate social relatedness in most situations... begins before age 5
Reactive Attachment Disorder is associated with _______ __________ _____
grossly pathogenic care
examples of stereotypic movement disorder
Waving, rocking, twirling objects, nailbiting, head-banging, picking at skin or body orifices
stereotypic movement disorder is associated with...
many metabolic, genetic, and neuroogic disorders and mental retardation ... cause unknown
tx for stereotypic movement disorder
no specific tx has been shown effective ...
drug tx for stereotypic movement disorder
anafranil and norpramin effective in severe nail biting... Halidol and thorazine effective in tx associated w/ mental retardation and autism
DSM-IV-TR sx for anorexia nervosa
- < or = to 85% body wt
- amenorrhea 3 consec cycles
- body image disturbance
- feelings of inneffectiveness
- need to control environment
long-term stats for anorexia
- 30% recover
- 30% partially improve
- 30% remain chronically ill
- 10% die of anorexia-related causes
Meds for bulemia
some positive response to SSRIs
long-term stats for bulimia
- 50% recover
- 20% continue to be bulimic
- 30% have episodic bouts of bulimia
- 1/3 of fully recovered clients have a relapse.
- death rate for bulimia is 3% or less
Biologic factors of eating disorders
- genetic vulnerability
- disruptions in the nuclei of the hypothalamus r/t hunger and satiety
- neurochemical changes
enmeshment
lack of clear role boundaries
drug tx for anorexia
- elavil and the antihistamine periactin can promote wt gain
- Xyprexia because of its effect on body image distortions
- Prozac prevents relapse
psychotheraputic tx for anorexia
family and individual therapy
drug tx for bulimia
antidepressants: Norpramin, tofranil, Elavil, Pamelor, Nardil, Prozac... only short term and only 25% effective
psychotheraputic tx for bulimia
cognitive-behavioral therapy... most tx is outpatient
alexithymia
difficulty identifying and expressing feelings
med tx for delirium
if restless or safety risk, low-dose antipsychotic (halidol .5-1 mg, may give IM) sedatives and benzodiazepines may worsen the delirium
tx for delirium caused by ETOH withdrawal
tx w/ benzodiazepines
Aphasia
deterioration of language
Apraxia
impaired motor function
Agnosia
inability to recognize names of objects
Disturbance in executive function
affects abstract thinking, planning, initiating, sequence, monitoring
difference in progression between vascular dementia and regular dementia
vascular dementia has a rapid and stepwise progression while alzheimers progress slowly
mild symptom of dementia
forgetfulness more than normal
moderate sx of dementia
confusion, more memory loss, oriented to person and place
Severe sx of dementia
personality changes, delusional, forgets names, needs assistance w/ ADLs
Genetic link to alzheimers?
Abnormal APOE gene r/t alzheimers
Pick's disease
degenerative brain disease affects frontal and temporal lobes - similar sx to alzheimers - age 50-60 - death in 2 to 5 years
Creutzfeldt-Jakob disease
cns disorder - age 40 to 60 - altered vision, los of coordination - progresses rapidly (months) - caused by an infections particle
Huntington 's disease
inherited , dominant disease - cerebral atrophy, demyelination, enlargement of ventricles.
sx of huntington's disease
facial contortions, twisting, turning, and tongue movements - personality changes, memory loss, decreased iiintellect. - 20 to 30 years to die
medication for dementia
Cognex, Aricept, Exelon, and Reminyl = cholinesterase inhibitors ... slow effect
- antidepresant
- antipsychotics
- mood stabilizers
Amnestic disorder
disturbance in memory resulting form the physiologic effects of a general medical condition
common sx of amnestic disorder
confusion, disorientation, and attentional deficits
Korsakoff's syndrome
ETOH induced amnestic disorder from chronic thimine or vit B deficiency
Asthenia
numbness
additional sx of depression in the elderly
hypochondriasis, somatization, worsening of sx of pre-existing conditions w/ out physical cause, irritability or agitation, asthenia, etc
cluster A personality disorders
Paranoid, schizoid, schizotypal,
cluster B personality disorders
antisocial, borderline, histronic, harcissistic
Cluster C personality disorders
avoidant, dependent, OCD
4 symptom categories for pharmacalogical tx in personality disorders
- cognitive-perceptual distortions, including psychotic sx
- affective sx and mood dysregulation
- aggression & behavioral dysfunction
- anxiety
Meds for cognitive-perceptual disturbances
low-dose antipsychotics
personality disorders
meds for mood dysregulation
Lithium, tegretol, depakote, low-dose neuroleptics, SSRIs, MAOIs, atypical antipsychotics
personality disorders
meds for aggression
Lithium, anticonvulsant mood stabilizers, benzodiazepines, and low-dose neuroleptics
personality disorders
anxiety meds
SSRIs, MAOIs, or low-dose antipsychotics
personality disorders
Defense mechanism used by paranoid personality disorder
projection - attribution of ones undesired impulses to another
nursing intervention for histronic personality disorder
give feedback about social interactions; teach social skills through role playing