Week 8 Study Materials: Focus on Pediatric Mental Health and Child Maltreatment in Nursing

ADHD (3 types):

-inattentiveness

-hyperactivity

-impulsiveness usually revealed prior to age 7

Risk factors for ADHD

-family history

-exposure to toxins or medications

-chronic otitis media, meningitis, or head trauma

S/s of ADHD:

-failure to pay close attention to detail

-blocking incoming stimuli

-difficulty sustaining attention

-hyperactivity

-impulsivity

Nursing considerations for ADHD:

-obtain history

-use calm, firm, and respectful approach with the child

-assist the family with modification of the environment to help the child be successful

-decrease stimuli around child

Autism Spectrum Disorder

spectrum of behaviors affecting an individual's ability to communicate and interact with others in a social setting

Risk factors for Autism:

-possible genetic component

-older parents

-fragile X syndrome or tuberculosis in

-exact cause unknown

S/s of Autism:

-delays in social interaction, communication, or imaginative play

-distress when routines are changed

-unusual attachments to objects

-delayed or absent language development

Nursing care for Autism:

-assist with screening assessment tools

-increase social awareness

-decrease unacceptable behaviors

-structure opportunities for small successes

Risk factors for Depression:

-family history

-traumatic event

S/s of Depression:

-withdrawn from family, friends, and activities

-tearful/crying

-fatigue

-weight loss or gain

-alterations in sleep

Nursing care for depression:

-obtain health history

-assess for substance use

-assess for actual or potential risk to self

-assist with coping strategies

Types of maltreatment (4):

physical

sexual

emotional

neglect

What is physical maltreatment?

Causing pain or harm to a child

-(shaken baby syndrome, fractures, factitious disorder imposed on another)

What is emotional maltreatment?

humiliating, threatening, or intimidating a child

-(includes behavior that minimizes an individual's feelings of self-worth)

What is neglect maltreatment?

failure to provide the following:

-Physical care: feeding, clothing, shelter, medical or dental care, safety, education

-Emotional care and/or stimulation to foster normal development: nurturing, affection, attention

Risk factors for child mistreatment for caregiver:

-young age

-having partner unrelated to the child

-social isolation

-low income situation

-lack of education

-substance use disorder

Risk factors for child mistreatment for children:

-children 1 year or younger (increased attention and demands)

unwanted/hyperactive/disabilities infants and children

-divorce, alcohol or substance use disorder, poverty

Shaken baby syndrome:

Shaking can cause intracranial hemorrhage. Caregiver’s frustrations with persistent crying can lead to this

S/s shaken baby syndrome:

-can have no external manifestations of injury

-vomiting, poor feeding

-respiratory distress

-seizures

-bulging fontanels

-retinal hemorrhages

Nursing care for shaken baby syndrome:

-identify as soon as possible

-observe for bruises or welts

-check the child for head injuries

-photograph and interview

S/s of oppositional defiant disorder (ODD):

-resists authority, disobeys, break rules

-argues

-anger outbursts

S/s of Conduct disorder:

-breaks laws, antisocial behavior

-aggressive towards people and/or animals

-destroys property

-steals

-deceives others

Risk factors for ODD/conduct disorder:

-genetic vulnerability

-child abuse history

-poor family functioning

-environmental adversity

-parents w/mental health disorders

Nursing care for ODD/conduct disorder:

-limit setting (rules and consequences)

-provide structure

-insist to clients to talk about feelings

S/s of anxiety disorder:

-generalized anxiety, fear, and worry-uncontrollable

-arousal

-fatigue

-concentration problems

-disturbed sleep

Nursing care for anxiety:

-help patient identify and express stressful feelings

-educate new coping strategies

-work on self esteem and safety

Externalizing disorders:

oppositional defiant disorder

conduct disorder

ADHD

-referred to as disruptive disorders

Internalizing disorders:

anxiety

depression

Nursing considerations for Adderall:

-appetite suppressant, administer after eating

-follow close to ensure right dose