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Pediatrics > Alteration in Cognition, Behavior, or Dev > Flashcards

Alteration in Cognition, Behavior, or Dev Flashcards

1
Q

Factor’s Influencing Children’s Behavior

A
  • biologic or genetics
  • nutrition
  • physical health
  • developmental ability
  • environment/family
  • temperament
  • family’s response to behavior
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2
Q

What are some techniques for evaluation?

A
  • clinical features
  • brain imaging
  • blood or urine toxicology
  • screening tools
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3
Q

Behavior Management Techniques

A
  • set limits and hold responsible for behavior
  • do NOT argue, bargain, or negotiate
  • consistent caregivers/daily routine
  • remain calm
  • ignore inappropriate behavior
  • praise self control
  • use restraints only when necessary
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4
Q

Psychostimulants

A

Methylphenidate TID

  • long acting preparations are given once daily in AM
  • decreased appetite; abdominal pain
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5
Q

Antianxiety

A

Buspirone

  • monitor for depression, confusion, agitation
  • may cause drowsiness
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6
Q

Antimanic

A

Lithium

  • monitor closely
  • polyuria, polydipsia
  • tremors, diarrhea
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7
Q

SSRI

A

fluoxetine, paroxetine, sertraline

  • monitor for BP increases
  • insomnia
  • GI distress
  • irritability
  • headache
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8
Q

Atypical Antidepressant

A

Trazadone

  • monitor BP for postural hypotension
  • observe for sedation and drowsiness
  • avoid alcohol
  • administer w/ meals or snacks
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9
Q

A-Agonist

A

Clonidine

  • strongly sedating
  • monitor BP and pulse
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10
Q

Tricyclic Antidepressants

A

Amitriptyline

  • monitor ECG for arrhythmias
  • monitor for anticholinergic effects
  • weight loss
  • check blood levels
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11
Q

Antipsychotics

A

Thioridazine, Chlorpromazine, Haloperidol

  • monitor for anticholinergic effects, drowsiness, dystonia, dizziness
  • drowsiness
  • evaluate for orthostatic HTN, tachycardia
  • observe for tardive dyskinesia
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12
Q

Assessments for a Child w/ Cognitive or Mental Health Disorder

A
  • health history
  • past medical history
  • history of neurologic injury or disease and family history of mental health disorder
  • developmental history
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13
Q

What are some behaviors related to mental health disorders?

A 
hallucinations 
aggression, impulsivity 
distractibility 
intolerance to frustration 
lack of sense of humor 
inhibition
poor attention span 
potential cognitive or learning disability 
unusual motor activity
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14
Q

What is the most sensitive early indicator of an intellectual disability?

A

delayed language development

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15
Q

Dyslexia

A

difficulty w/ reading, writing, and spelling

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16
Q

Dyscalculia

A

difficulty w/ math and calculations

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17
Q

Dyspraxia

A

problems w/ manual dexterity and coordination q

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18
Q

Dysgraphia

A

difficulty producing the written word

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19
Q

Sensory Processing Disorder

A

may be mistaken for a learning disability, but it is not and should be treated differently

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20
Q

What is the criteria for being diagnosed w/ an Intellectual Disability?

A
  • deviations in IQ of two or more standard deviations
  • coexisting deficits in at least 2 adaptive skills
  • disability occurring before the age of 18
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21
Q

Mild Intellectual Disability

A

IQ 50-70

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22
Q

Moderate Intellectual Disability

A

IQ 35-50

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23
Q

Severe Intellectual Disability

A

IQ 20-35

24
Q

Profound Intellectual Disability

A

IQ less than 20

25
Q

What are the warning signs of autism?

A
  • not babbling by 12 months
  • not pointing or using gestures by 12 months
  • no single words by 16 months
  • no 2 word utterances by 24 months
  • losing language or social skills at any age
26
Q

What are some possible etiologies of autism?

A
  • genetic makeup
  • brain abnormalities
  • altered chemistry
  • virus
  • toxic chemicals
27
Q

Autism Screening Tools

A
  • Checklist for Autism in Toddlers (CHAT)
  • Modified Checklist for Autism in Toddlers (M-CHAT)
  • Social Communications Questionnaire (SCQ)
  • Pervasive Developmental Disorders Screening Test II (PDDST-II)
28
Q

What to look for when assessing an Autistic Child?

A

-lack of eye contact
-failure to look at objects
-failure to point to himself
-failure to let his or her needs known
-perseverative play activities
-hand flapping
spinning

29
Q

Nursing Interventions for Autism

A
  • provide emotional support
  • professional guidance and education
  • assess fit b/t developmental needs and treatment plan
  • help parent’s overcome barriers
  • stress importance of rigid, unchanging routines
  • assess need for respite care
  • provide positive feedback
30
Q

What is ADHD characterized by?

A

inattention, impulsivity, distractibility, and hyperactivity

31
Q

What are the 3 subtypes of ADHD?

A
  • hyperactive-impulsive
  • inattentive
  • combined
32
Q

Tourette Syndrome

A

multiple motor tics and one or more vocal tics occurring either simultaneously or at different times

33
Q

What are 2 comorbid conditions that occur 60% of the time w/ Tourette’s?

A

ADHD

Obsessive compulsive disorder

34
Q

When do tics become more noticeable for a child w/ Tourette’s?

A

during times of stress

35
Q

What are the 4 types of eating disorders?

A
  • pica
  • rumination
  • anorexia nervosa
  • bulimia
36
Q

Pica

A
  • 2-3 years old

- ingests a nonnutritive material such as clay, paint, or sand for at least 1 month

37
Q

Rumination

A

infants which regurgitate partially digested food/formula and then expel or swallow it

38
Q

Anorexia Nervosa

A

dramatic weight loss as a result of decreased food intake and sharply increased physical exercise

39
Q

Bulimia

A

cycle of normal food intake, followed by binge-eating and then purging

40
Q

Complications of Anorexia Nervosa and Bulimia

A
  • fluid and electrolyte imbalance
  • decreased blood volume
  • cardiac arrhythmias
  • esophagitis
  • rupture of esophagus or stomach
  • tooth loss
  • menstrual problems
  • mortality rate as high as 18%
41
Q

Mood Disorders

A
  • depressive disorders
  • bipolar disorder
  • anxiety disorder
  • mood control
42
Q

Teaching Topics for Mood Disorders

A
  • mood disorders are biologic conditions not personality flaws
  • teach how to administer antidepressant meds and monitor for adverse effects
  • encourage for following through w/ therapies
  • support family
  • refer to local support resources
43
Q

What are some disorders that may be seen w/ depression?

A
  • suicide
  • anxiety disorders
  • substance abuse
  • eating disorders
  • self harm
  • disruptive behavioral disorders
44
Q

Risk Factors for Suicide

A
  • previous suicide attempt
  • change in school performance, sleep, or appetite
  • loss of interest in formerly favorite school or other activities
  • feelings of hopelessness or depression
  • statements about thoughts of suicide
45
Q

Types of Anxiety Disorders

A
  • generalized anxiety disorder
  • social phobia
  • selective mutism
  • separation anxiety
  • obsessive compulsive disorder
  • posttraumatic stress disorder
46
Q

Generalized Anxiety Disorder

A

unrealistic concerns over past behavior, future events, personal competence

47
Q

Social Phobia

A

persistent fear of speaking or eating in front of others, using public bathrooms, or speaking to authority

48
Q

Selective Mutism

A

persistent failure to speak

49
Q

Separation Anxiety

A

close to parents; worry focuses on separation

50
Q

Obsessive Compulsive Disorder

A

compulsions performed to reduce anxiety about obsessions

51
Q

Compulsions

A

repetitive behavior such as cleaning, washing, checking something

52
Q

Obsessions

A

unwanted and intrusive thoughts

53
Q

PTSD

A

an anxiety disorder that occurs after a traumatic event

54
Q

Types of Abuse/Violence Leading to Mental Illness

A
  • child maltreatment
  • Munchausen syndrome
  • Substance abuse
55
Q

Munchausen Syndrome

A

type of child abuse in which the parent creates a physical/psychological illness, symptoms, or impairment in the child

56
Q

Warning Signs of Munchausen Syndrome

A
  • child w/ 1 or more illnesses that don’t respond to treatment or follow a puzzling course; similar history in siblings
  • symptoms that don’t make sense or that disappear when the perpetrator is removed
  • physical & lab findings that don’t fit w/ reported history
  • repeated hospitalizations failing to produce a diagnosis, transfers to other hospitals
  • parent who refuses to accept that the diagnosis is not medical

Pediatrics (24 decks)

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