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2 Behavior Disorders
- ADHD
- OPPOSITIONAL DISORDER
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2 PEVASIVE DEVELOPMENTAL DISORDERS
- AUTISM
- ASPERGER'S DISORDER
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When is ADHD primarily diagnosed
in childhood but may carry over into adulthood
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what are the 3 varieties of ADHD
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Predominately hyperactivimpulsive
- Predominately inattentive
- Combined type
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Who is Hyperactivity-impulsive more predominant in
Males
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Hyperactivity-impulsive is usually diagnosed by who
teacher or parent
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hyperactivity-impulsive is usually symptomatic in what age group
childhood
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what kind of behavior does hyperactivity-impulsive usually display
dusruptive behavior
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Is Hyperactivity-impulsive a family linked problem
Yes!
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Inattentive ADHD is characterized by
poor attention span, and poor task skills, doesn't appear to listen when spoken to, and they are easily distracted.
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Combined type is characterized by
inattention, hyperactivity, impulsicity,
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how long must combined ADHD symptoms be present to be diagnosed with it
6 months
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Treatment for ADHD (Counceling/Therapy)
have a positive behavior or reward system
need highly structured environment with firm, consistent limits with appropriate consequences for disruptive, unruly behavior
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Treatment for ADHD (medication)
These meds are stimulants that instead of creating them more hyperactive they do the opposite effect.
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Stimulant Meds
- Methylphenidate
- (Ritalin, Concerta)
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Nonstimulant meds
Strattera
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what is the goal of strattera
increase attention and goal directed behavior.
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what are the signs of overdose
(mild) restlessness, nervousness, insomnia
(severe) panic, hallucinations, circulatory collapse, seizures.
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what do you as a nurse want to monitor on a pt with ADHD
monitor development, height and weight, subjective/objective data, overdose
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what do you want to teach the client and the parents
to give meds in the am with breakfast and if 2nd dose is required give with lunch
Monitor for vocal and motor tics: meds need to be stopped!!
Avoid chewing time released meds(concerta)
Avoid alcohol OTC and cold or decongestant meds
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Oppositional Defiant Disorder
is a recurrent pattern of antisocial behavior
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what do oppositional defiant disorder usually display
negativity, disobedience, hostility, defiant behaviors toward authority, stubbornness, argumentativeness, limit testing, unwillingness to compromise, refusal to accept responsibility for misbehavior.
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How do Oppositional Defiant clientsusually view themselves
Not self Defiant; and see others as unreasonable
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what gender usually have Oppositional Defiant Disorder
Males; before puberty
Equal in male and females after puberty
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Autism is
an abnormal brain function affecting language, logic and reasoning ability
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Autism impairs communications how
language delay, echolalia, failure to imitate
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Autism impairs social interaction how
lack of responsiveness to and interest in others, lack of eye-to-eye contact, failure to cuddle or be comforthed lack of friendships
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rigid adherence to clapping, rocking, flappinh, banging etc, observed before age 3, more common in males than females, skills enhanced?
sterotypical behavoirs
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this disease occurs later in childhood, school age, relationships are difficul and more common in males than females
aspergers disorder
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a situation where in basic need of the client is not being provided. ex: clothing, food, shelter, absence of nurturing
neglect
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an incident involding some type of violation to the client. ex: physical, emotional, psychological, sexual in nature
abuse
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women are more highly likely to be abused but what percent of men are?
30-40
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types of abuse or violence?
physical, emotional, neglect, sexual, economic
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family violence has 3 phases what are they?
tension, serious battering, honeymoon
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minor episodes of anger, may be verbally, abusive, victim takes responsibility for causing anger, accepts blame
tension building phase
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tension becomes to much, incidents occus, victim attempts to cover up inhury
serious battering phase
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abuser becomes loving, promisese to change and is osrry, the victim wants to believe this is tru
honeymoon phase
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how can we assess infant for violence or abuse?
intracranial hemorrhage, resp distress, bulging fontanels, increased head circumference, bruising before 6 mo
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how do we assess for head injuries?
LOC, n/v and reactive pupils
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other ways to note of abuse on children?
assess for gloved hands or burning, belt shaped lashes or bruises, shapes, forearm spirals reults from grabbing and twisting, bite marks
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assessment of older adults and abuse?
bruises, lacerations, abraisions, fracture with physical appearance does not match history of machanisms of injury
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legal intoxication level?
.08%
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death can occur from acute toxic levels greater than ?
0.35%
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stage 1 of alcohol withdrawl
minor- restless, anxious, sleeping problems, agitation, tremors, low fever, tachycardia, diaphoresis, hypertension
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stage 2 withdrawl?
major- includes stage 1 symptoms, delusions/hallucinations, tremors, pulse >100, possible vomit
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stage 3 withdrawl?
delirium tremens-temp of 100, diorientations, confusions, irritable
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benzos that aide in the maintenance of v/s and decrease seizure risk
tegretol, catapress, inderal
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daily oral med that is a type of aversion (behavioral) therapy
antabuse (disulfiram)
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inflammatory hemmorrhagic and degenerative condition of the brain caused by a thiamine deficiency
wernicke's encephalopathy
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s/s of wernickes
delirium, memory loss, unsteady gait, altered LOC
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Thiamine and b12 deficiences contributes to this
korsakoff's psychosis
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s/s of Korsakoff's?
disorientation, amnesia, insomnia, hallucinations and peripheral nervouse system
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3 criterias for FAS?
- 1- retardation growth
- 2-CNS involvement(delay or impairment)
- 3-craniofacial impairment, microcephaly, head circumference below 3%, thin upper lip, etc
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if an infant meets 1 but not 3 criteria then what?
diagnosed with FAE
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intended affect of opiods?
euphoria, pain relief, pupil constriction, constipation
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if a drug user is having a withdrawl and trying to wean themselves they are usualy put on ?
methadone
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amphetamines intended effect?
increased energy, euphoria
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toxic effects of amphedimines?
irritability, psychosis, pos death'
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withdrawl of amphetamines
craving depression, fatigue and sleepy
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CAGE assessment?
to determine if someone may have an issue with using or drinking
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C in cage?
has anyone ever told you that you should CUT down on your drinking/drug use?
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A in cage?
have people ANNOYED you by critizing your drinking/using drugs?
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G in cage?
have you ever felt GUILTY for drinking/drug use?
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E in cage?
have you ever taken an EYE-opener (morning drink or drug) to steady your nerves or get rid of a hangover?
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11th leading cause of death?
suicide
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