Download 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
____________________________________
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