Mental Health Nursing II NURS 2310

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Mental Health Nursing IINURS 2310

• Unit XIII
• Psychiatric Conditions Affecting Children and
  Adolescents

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Objective 1

• Identifying etiology and characteristics of
  specified childhood/adolescent psychiatric
  illnesses

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• Disorders Affecting Children/Adolescents
• ____________________________________
• Mental Retardation
• Autistic Disorder
• Attention-Deficit/Hyperactivity Disorder
• Conduct Disorder
• Oppositional Defiant Disorder
• Tourettes Disorder
• Separation Anxiety Disorder

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• Mental Retardation
• Involves deficits in general intellectual
  functioning and adaptive functioning
• General intellectual functioning measured by an
  individuals performance on IQ tests
• Adaptive functioning refers to the persons
  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, self-care,
  self-direction, leisure, and safety

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• Mental Retardation (contd)
• Predisposing factors
• Hereditary
• Approximately 5 of cases
• Downs 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
  disorders

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• Autistic Disorder
• Characterized by a withdrawal into the self and
  into a fantasy world of ones 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

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• 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

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• ADHD (contd)
• 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

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• 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

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• 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

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• Tourettes 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

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• 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

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Objective 2

• Examining medical treatments and nursing
  interventions for clients experiencing a
  childhood/adolescent psychiatric disorder

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• 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

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Objective 3

• Exploring concerns associated with providing
  psychiatric care to children and adolescents

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• 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

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Objective 4

• Applying the nursing process to the treatment of
  special populations

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• Assessment
• Nursing Diagnosis
• Planning
• Implementation
• Evaluation