wk 10 children and adolescents

ch 23

austim spectrum disorder (ASD)

• developmental delay

  • easier to miscommunicate

• impaired social interaction

  • blunt, unable to read room

• increased sensitivity to stimuli and sensations

  • stimming (can be dangerous)

• hyperfixations 

austim spectrum disorder nursing diagnoses (7)

• impaired social interactions

• activity intolerance

• impaired verbal communication

• impaired social interaction

• risk for injury

• ineffective coping

• anxiety

austim spectrum disorder interventions

• use short, concise developmentally appropriate communication

• routine changes

• limit self-stimulating and ritualistic behaviors 

  • decrease stimuli

  • provide alternative play activities

wyd if routine changes for autistic pt who is looking forward to group at 11:30? is it better to let them know early or when it happens?

let them know ahead of time

“group will happen, it will just be delayed a little bit”

• less chance of a meltdown instead of finding out all of a sudden

attention deficit hyperactivity disorder (ADHD) characteristics and how it affects them

characterized by inattentive, hyperactive, impulsive

• impaired social and academic functioning

• difficulty in performing appropriate tasks

• disruptive and distractable

• limited attention span

attention deficit hyperactivity disorder nursing diagnoses

• risk for injury

• impaired social interactions

• low self esteem

• non-compliance

attention deficit hyperactivity disorder interventions

• encourage appropriate/cooperative behavior

• decrease stimuli

• keep them active and busy!

  • ex: music, drumming, table tennis

• social skills training

attention deficit hyperactivity disorder psychopharmacology types

• cns stimulants

• non stimulants

ADHD CNS stimulants

• amphetamines

  • dextrostat, adderall, vyvanse

• methylphenidate

  • ritalin, concerta, focalin, daytrana patch

ADHD non-stimulants

• atomoxetine

• buproprion

• clonidine

attention deficit hyperactivity disorder side effects

• insomnia

• dysrhythmias

• anorexia, weight loss

• growth suppression

• dependence

attention deficit hyperactivity disorder nursing considerations

• actions and sides effects differ for everyone

• benefits must outweigh

tourette’s disorder requirements (including duration)

multiple motor tics and at least one vocal tic for more than a year

• child is not faking it!

  • can change in frequency and severity

tics

sudden, involuntary, and repetitive movement or vocalization

• grunting, barking, sniffing

• echolalia

tourette’s disorder nursing diagnoses

• low self esteem

• impaired social interaction

• risk for self-directed or other-directed violence

tourette’s disorder intevention options

• therapies

• psychopharmacology

tourette’s disorder therapies

• CBT

• DBT

• Speech Therapy

tourette’s disorder psychopharmacology

• risperidone or aripiprazole to address irritability and self-injury

• SSRI for improved mood and reduced anxiety

• muscle relaxants for facial spasms (for physical tics)

oppositional defiant disorder (ODD)

• defiant kids

• angry and irritable

• hateful and wants to get even

• fights authorities

not really a danger to themselves or others

ex: cailou (lol)

conduct disorder & what dx is it similar to

• aggressive behavior

• societal norms disregarded

• lacks empathy

ppl actually get hurt, no remorse

gets riled up and makes things worse

antisocial personality disorder JR — same interventions

ODD and Conduct disorder nursing diagnoses

• risk for other directed violence

• impaired social interaction

• defensive coping

• low self-esteem

• noncompliance with therapy

ODD and Conduct Disorder Interventions

do meds help?

• limit setting

• use a calm and assertive approach

• short, clear expectations

• reduce stimili

meds and not rlly helpful