Mental Health Mental Health Nursing IINursing II

NURS 2310NURS 2310

Unit 11Unit 11

Psychiatric Conditions Psychiatric Conditions Affecting Children and Affecting Children and

AdolescentsAdolescents

Objective 1Objective 1

Identifying etiology and characteristics of specified

childhood/adolescent psychiatric illnesses

Disorders Affecting Children/Adolescents____________________________________

Intellectual Developmental DisorderAutism Spectrum Disorder

Attention-Deficit/Hyperactivity DisorderOppositional Defiant Disorder

Conduct DisorderTourette’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,

self-care, 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 2Objective 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 3Objective 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 4Objective 4

Applying the nursing process to the

treatment of special populations

Assessment

Nursing Diagnosis

Planning

Implementation

Evaluation