Mental Health Nursing II NURS by mikeholy


									Mental Health Nursing II
      NURS 2310
         Unit XIV
  Psychiatric Conditions
  Affecting Children and
         Objective 1

    Identifying etiology and
   characteristics of specified
childhood/adolescent psychiatric
 Disorders Affecting Children/Adolescents

            Mental Retardation
             Autistic Disorder
  Attention-Deficit/Hyperactivity Disorder
             Conduct Disorder
       Oppositional Defiant Disorder
            Tourette’s Disorder
       Separation Anxiety Disorder
                Mental Retardation
   Involves deficits in general intellectual
    functioning and adaptive functioning
    – General intellectual functioning = measured by
      an individual’s performance on IQ tests
    – Adaptive functioning = refers to the person’s
      ability to adapt to the requirements of daily
      living and the expectations of age and cultural
 IQ is 70 or below
 Deficits/impairment in communication, self-
  care, self-direction, leisure, and safety
             Mental Retardation (cont’d)
   Predisposing factors:
    – Hereditary
        Approximately 5% of cases
        Down’s syndrome, Tay-Sachs disease
    – Early alterations in embryonic development
        Drug/alcohol toxicity
        Maternal illnesses/infections
    – Pregnancy and prenatal problems
        Birth injuries
    – General medical conditions acquired in infancy
      or childhood
    – Environmental influences and other mental
               Autistic Disorder
 Characterized by a withdrawal into the self
  and into a fantasy world of one’s own
 Development in social interaction and
  communication is markedly abnormal or
 Activities and interests are restricted; may
  be considered bizarre
 Prevalence of approximately 1 in 150
  children in the U.S.
 Onset occurs before age 3
    Attention-Deficit/Hyperactivity Disorder
 Persistent pattern of inattention and/or
  hyperactivity-impulsitivity that is more
  frequent and severe than is typically
  observed in individuals at same
  developmental level
 Hyperactivity = excessive psychomotor
  activity that may be purposeful or aimless,
  accompanied by physical movements that
  are usually more rapid than normal
 Impulsitivity = acting without reflection and
  without thought to the consequences
                  ADHD (cont’d)
 Onset of disorder difficult to diagnose in
  children younger than age 4
 ADHD often not recognized until child
  enters school
 Five to nine times more common in boys
  than in girls
 Believed to have strong genetic component
    – Parent with ADHD may have child with ADHD
    – Sibling string
   Possible link to high serum lead levels
              Conduct Disorder
 Repetitive and persistent pattern of
  behavior in which basic rights of others or
  major age-appropriate societal norms or
  rules are violated
 Physical aggression common
 Childhood-onset = begins prior to age 10;
  more likely to have continued problems
  during adolescence, and antisocial as adult
 Adolescent-onset = absence of any criteria
  characteristic of conduct disorder before
  age 10
    Oppositional Defiant Disorder (ODD)
 Characterized by a pattern of negativistic,
  defiant, disobedient, and hostile behavior
  toward authority figures that occurs more
  frequently than is usually observed in
  individuals of same age/developmental
 Typically begins by age 8, and usually not
  later than early adolescence
 May precede a conduct disorder
 “Normal” oppositional phases occur in older
  infancy, toddlerhood, and adolescence
             Tourette’s Disorder
 Presence of multiple motor tics along with
  one or more vocal tics
 Tics may appear simultaneously or at
  different periods during the illness
 Causes marked distress or interferes with
  various areas of functioning
 Onset occurs before the age of 18
 Characterized by periods of remission
 Symptoms usually diminish during
  adolescence and adulthood
         Separation Anxiety Disorder
 Involves excessive anxiety concerning
  separation from the home or from those to
  whom the person is attached
 Considered in excess of what would be
  expected for developmental level
 Interferes with social, academic, and
  occupational levels of functioning
 More common in girls than in boys
 Etiological factors may include stressful life
  events and/or family influences
                 Objective 2

Examining medical treatments and
  nursing interventions for clients
           experiencing a
  childhood/adolescent psychiatric
   Behavior Therapy
    – Classical conditioning, operant conditioning
    – Useful for disruptive behavior disorders
 Family Therapy
 Family Education
    – Behavior modification techniques
    – Consistency
   Group Therapy
    – Opportunity to interact with peers
    – Learning of appropriate social behaviors
   Psychopharmacology
           Objective 3

Exploring concerns associated with
    providing psychiatric care to
      children and adolescents
   Medication issues
    – Dosing problems
    – Addiction
   Legal issues
    – Guardianship concerns
    – Safety
   Developmental issues
    – Appropriateness of behaviors compared to norms
      of life stage
   Parental/caregiver issues
    – Manipulation of health care system
    – Knowledge deficits
Objective 4

    Applying the nursing
  process to the treatment
   of special populations
   Assessment

   Nursing Diagnosis

   Planning

   Implementation

   Evaluation

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