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