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64 Cards in this Set
- Front
- Back
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The Pediatric Client
Are not age appropriate. Deviate from cultural norms. Create deficits or impairments in adaptive functioning. |
The Pediatric Client
Behavioral signs that an emotional problem exists. |
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The Pediatric Client
What axis is Mental Retardation? |
The Pediatric Client
Axis II |
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The Pediatric Client
Subaverage intelligence accompanied by impairments in performing age-expected activities in daily living. Etiology varies from specific genetic abnormalities to environmental factors. |
The Pediatric Client
Mental Retardation |
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The Pediatric Client
Intelligence quotient below 70? |
The Pediatric Client
Subaverage intelligence MR |
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The Pediatric Client
Fragile X syndrome, trisomy 21, phenylketonuria? |
The Pediatric Client
Genetic Abnormalities |
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The Pediatric Client
What are the characteristics of MR by degree of severity? |
The Pediatric Client
Mild Moderate Severe Profound |
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The Pediatric Client
Capable of independent living, with assistance during times of stress; Academic skills to 6th grade level; Capable of developing social skills; As adult, can achieve vocational skills for minimum self-support, I.Q. score between 55 and 69? |
The Pediatric Client
Mild MR |
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The Pediatric Client
Can perform some activities independently - requires supervision; Academic skills to 2nd grade level; As adult could work in sheltered workshop; Possibly some limitation in speech; Difficulty adhering to social convention may interfere with peer relationships, I.Q. score from 40-54? |
The Pediatric Client
Moderate MR |
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The Pediatric Client
Requires complete supervision; Unable to benefit from academic or vocational training; Minimal verbal skills; Wants and needs communicated by acting-out behaviors, I.Q. score 25-39? |
The Pediatric Client
Severe MR |
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No capacity for independent functioning; Requires constant aid and supervision; Unable to benefit from academic or vocational training; Little, if any speech development. No capacity for socialization skills, I.Q. score <25?
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The Pediatric Client
Profound MR |
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The Pediatric Client
Safety!; Family, care givers, etc. are familiar with capabilities; Realistic expectations; Same staff; Accompany to new situations. |
The Pediatric Client
Nursing Care in autism, asperger's and mental retardation. |
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Characterized by impairments across multiple domains of development; Share several common features: Delayed socialization, Stereotypical behaviors: hand flapping, rocking, peculiar preoccupations, rigid and intolerant of change in routines, behavioral outbursts in response to modest demands.
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The Pediatric Client
PDD - Pervasive Developmental Disorders |
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The Pediatric Client
What is PDD? |
The Pediatric Client
Pervasive Developmental Disorders |
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The Pediatric Client
Strong genetic contribution; Studies looking at serotonin serum levels and structure of serotonin receptors; Early age of onset (before 30 months of age); Social relatedness profoundly disturbed; Communication is delayed and deviant; Delayed developmental profile is relatively constant. |
The Pediatric Client
Autistic Disorder |
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The Pediatric Client
More common in males than females; No genetic marker identified, however the disorder tends to run in families, with high recurrence in fathers; Often have normal intelligence; Verbal intelligence is typically higher than performance intelligence. |
The Pediatric Client
Asperger's Disorder |
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The Pediatric Client
Evidence indicating large number of parents of hyperactive children showed signs of hyperactivity during own childhood. |
The Pediatric Client
Genetic Etiology of Disruptive Disorders |
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The Pediatric Client
Abnormal levels of dopamine, norepinephrine, and possibly serotonin may be associated with symptoms of hyperactivity, impulsivity, mood and aggression. |
The Pediatric Client
Biochemical Etiology of Disruptive Disorders |
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The Pediatric Client
Implicate alterations in frontal lobes, basal ganglia, caudate nucleus and cerebellum. |
The Pediatric Client
Anatomical Etiology of Disruptive Disorders |
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The Pediatric Client
Maternal smoking during pregnancy; Intrauterine exposure to toxic substances (Etoh); Prematurity, fetal distress; Environmental - lead exporsure; Psychosocial - chaotic environments. |
The Pediatric Client
Other etiological factors implicated in Disruptive Disorders. |
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The Pediatric Client
Stimulants; methylphenidate (Ritalin); dextroamphetamine (Dexedrine); D,L-amphetamine (mixed compound) Adderall. |
The Pediatric Client
Pharmacological Nurcing Care |
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The Pediatric Client
Stimulants; methylphenidate (Ritalin); dextroamphetamine (Dexedrine); D,L-amphetamine (mixed compound) Adderall. All have what kind of effect? |
The Pediatric Client
They all have paradoxical effect. |
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The Pediatric Client
Methylphenidate D.L-amphetamine are what type of drug? |
The Pediatric Client
Stimulants |
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The Pediatric Client
Optimal daily dosage 0.6 to 1.5 mg/kg body weight/ day in 3 divided doses = doses above 60mg. Say not recommended. |
The Pediatric Client
methylphenidate/Ritalin |
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Typical daily dose is 10 to 20 mg/day young children and 30 to 40 mg/day older child.
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The Pediatric Client
D,L-amphetamine (mixed compound) Adderall |
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The Pediatric Client
Safety, Decrease stimulus, "Catch them being good", Speak to their behavior, Work with their short-attention-span, Work with child 1:1, Ensure goals are realistic. |
The Pediatric Client
Nursing Care for ADHD ADD |
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The Pediatric Client
Enduring pattern of disobedience, argumentativeness, explosive angry outbursts, low frustration tolerance, and tendency to blame others; Frequently in conflict with adults; Have trouble maintaining friendships; Typically more prevalent in boys than girls before puberty, but rates more = after puberty. |
The Pediatric Client
Oppositional Defiant Disorder |
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The Pediatric Client
What is a developmental antecedent to Conduct Disorder? |
The Pediatric Client
Oppositional Defiant Disorder |
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The Pediatric Client
Most serious of Disruptive Disorders; Distinguishable from ODD because it is characterized by more serious violations of social standards: cruelty to animals, numerous and on-going studies by FBI show strong evidence of relationship to cruelty/abuse of animals and later violent crimes; Mass murderers have all engaged in animal cruelty/abuse as children, adolescence and adulthood. |
The Pediatric Client
Conduct Disorder |
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Physical aggression: Violate basic rights of others: Steal, vandalize; Fire-setting; Break into homes, schools, businesses; Confrontational crime as well as non-confrontational crime; sexual activity; use weapons; alcohol, drug use; do not experience remorse - no feelings of guilt; bullies; forgery.
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The Pediatric Client
Conduct Disorder |
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The Pediatric Client
Separation Anxiety D/O; Onset as early as pre-school age - rarely as late as adolescence; School refusal common in adolescence; younger children "shadow" the person from whom they are afraid of being separated; Worry is common; Phobias common; Depressed mood frequently present. |
The Pediatric Client
Adjustment Disorders |
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The Pediatric Client
Manifestations similar to those observed in adults with 2 important differences: Less able to verbalize their feelings, irritability might be the predominant feature with children and adolescents. |
The Pediatric Client
Mood Disorders - Major Depression |
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The Pediatric Client
In contrast to classic mania seen in adults: Children who exhibit manic symptoms are often significantly impaired between manic episodes; Children always have a mood disturbance. |
The Pediatric Client
Mood Disorders - Bi Polar D/O |
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The Pediatric Client
Typically rapid, jerky movements of eyes, face, neck and shoulders (can include other muscle groups); can also take form of slower, more purposeful movements. |
The Pediatric Client
Tic Disorders |
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The Pediatric Client
Throat clearing, grunting or other repetitive noises. |
The Pediatric Client
Phonic Tics |
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The Pediatric Client
3 to 6 x's more common in boys than girls. |
The Pediatric Client
Tourettes Syndrome - TS |
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The Pediatric Client
Children are physiologically different from adults: Impact - dose, clinical response, side effects. Children often require larger doses of psychotropic drugs on mg/kg basis, than adults; Pharmacodynamics might be different with children than adults (developmental differences in neural pathways) i.e., inconsistent effects of TCA's in children with Depression and more frequently seen activating effects of the SSRI's in children. |
The Pediatric Client
Pediatric Psychopharmacology |
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Inattention; Hyperactivity or Impulsivity; Restless; Distractable; Reckless; Disruptive; Extremely limited attention span; Forgetting to do or turn in homework; Failure to hear or follow directions; Talking excessively and inappropriately; Constantly moving; Not remaining seated during class; Losing objects, especially those related to school?
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Characteristics and Primary Symptoms of Attention Deficit-Hyperactivity Disorder.
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Adolescents tend to have less hyperactivity but have the inattention and impulsive symptoms?
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Attention Deficit-Hyperactivity Disorder.
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Most often, child does not grow out of it - continues through adolescence and adulthood?
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Attention Deficit-Hyperactivity Disorder
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Stimulant medication is the primary pharmocologic treatment. Caue increased availability of dopamine and norepinephrine (deficits of norepinephrine and dopamine lower the threshold for stimuli input). Adequate levels of dopamine necessary for concentration and attention span?
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Part of Pharmacological Nursing Care in Attention Deficit-Hyperactivity Disorder
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Paradoxical effect; increase concentration, decrease aggression; decrease impulsivity and hyperactivity?
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How CNS Stimulant treats ADHD.
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What are the most commonly used medications in ADHD?
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Ritalin, Concerta (methylphenidate)
Dexedrine (dextroamphetamine) Adderall (a combination of mixed amphetamine salts) |
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How long do Concerta's effects last in treating ADHD?
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10 to 12 hours.
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How long do most medications used in ADHD act?
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Most are short acting (lasting 3-5 hours)
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How long does Adderall's effects last in treating ADHD?
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Longer than 3-5 hours but less and 10-12 hours.
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What is the non-stimulant medication used in the treatment of ADHD?
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Strattera (atomoxetine)
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Is Strattera (atomoxetine) a controlled substance?
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No.
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Insomnia; Anorexia; May lower seizure threshold; Worsening of pre-existing tics; Restless; Palpitation; Dependence?
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Side effects of Stimulant Medications in ADHD.
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What are the other medications used in ADHD?
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TCA's
Wellbutrin (bupropion) Clonidine |
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What are the two "things" on Axis II?
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Personality Disorders and Mental Retardation
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The Pediatric Client
Stages of Healing of Bruises Less than 24 hours? |
The Pediatric Client
Stages of Healing of Bruises Red to red-blue. |
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The Pediatric Client
Stages of Healing of Bruises 1-4 days? |
The Pediatric Client
Stages of Healing of Bruises Purple to dark blue. |
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The Pediatric Client
Stages of Healing of Bruises 5-7 days? |
The Pediatric Client
Stages of Healing of Bruises Green to yellow-green. |
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The Pediatric Client
Stages of Healing of Bruises 7-10 days? |
The Pediatric Client
Stages of Healing of Bruises Yellow to brown. |
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The Pediatric Client
Stages of Healing of Bruises 1-3 weeks? |
The Pediatric Client
Stages of Healing of Bruises Disappearance. |
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The Pediatric Client
The pediatric patient with autism may engage in echolalia, which is? |
The Pediatric Client
Repeating the last few words that you say. |
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The Pediatric Client
What pedicatric client has a hard time with personal pronouns? |
The Pediatric Client
The pediatric client with autism. |
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The Pediatric Client
No abstract thinking, cannot pick up on mental cues, and sometimes has mental retardation? |
The Pediatric Client
The pediatric client with autism. |
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The Pediatric Client
Does an Asperger's client usually have mental retardation? |
The Pediatric Client
No. It can happen but not usually. |
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The Pediatric Client
Often perfectionists and hate to fail? |
The Pediatric Client
Asperger's client. |
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The Pediatric Client
Usually what we would give positive reinforcement for, in Asperger's and especially autism, is for? |
The Pediatric Client
Eye contact. |
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The Pediatric Client
How is it recommended to give the CNS stimulants because of GI upset? |
The Pediatric Client
Before or wiith meals. |
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The Pediatric Client
What disorder that for at least 6 months, client has a pattern of histile, negative, and defiant behavior, with at least four of the following: Frequently loses temper; Argues with adults; Is actively defiant or refuses to follow rules; Deliberately annoys others; Frequently blames others for mistakes or misbehavior; Seems touchy or easily annoyed by others; Is often angry and resentful; Shows spitefulness or vindictiveness? |
The Pediatric Client
Oppositional-Defiant Disorder |
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The Pediatric Client
What disorder has: Aggression to people and animals Destruction of property Deceitfulness or theft Serious violations of rules? |
The Pediatric Client
Conduct Disorder |
