Mental Health Nursing II NURS 2310
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Transcript Mental Health Nursing II NURS 2310
Mental Health Nursing II
NURS 2310
Unit 11
Psychiatric Conditions
Affecting Children and
Adolescents
Objective 1
Identifying etiology and
characteristics of specified
childhood/adolescent psychiatric
illnesses
Disorders Affecting Children/Adolescents
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Intellectual Developmental Disorder
Autism Spectrum Disorder
Attention-Deficit/Hyperactivity Disorder
Oppositional Defiant Disorder
Conduct Disorder
Tourette’s Disorder
Separation Anxiety Disorder
Intellectual Developmental Disorder
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
group
IQ is 70 or below
Deficits/impairment in communication, selfcare, self-direction, leisure, and safety
Intellectual Developmental Disorder (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 early childhood
– Environmental influences and other mental
disorders
Autism Spectrum Disorder
Characterized by a withdrawal into the self
and into a fantasy world of one’s own
creation
Development in social interaction and
communication is markedly abnormal or
impaired
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
(ADHD)
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
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
level
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
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
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
disorder
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