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EXAM 4 MENTAL HEALTH

Autism & ADHD

QuestionAnswer
Autism Spectrum Disorder (ASD) Risk Factors More Prevalent in girls. Does have a genetic link
Autism Spectrum Disorder (ASD) Common Behaviors Not responding to their name by age 1, Doesn't show interest by pointing to objects or people by 14 months, Doesn't play pretend games by 18 months, Avoids eye contact, Prefers to be alone, Delayed speech and language skills, Obsessive interests (stuck on an idea), Upset by minor changes in routine, Repeats word or phrases over and over, Flaps hands, or rocks, spins in a circle, answers unrelated questions, Unusual reactions to sounds, smells, or other sensory experiences
Most common and stereotyped Motor Behaviors of patients with ASD Flapping hands, body twisting, head banging
Stereotypic Movement Disorder Characterized by rhythmic, repetitive behaviors, such as hand waving, rocking, headbanging, and biting, that appears to have no purpose. Self-inflicted injuries are common. Pain is not a deterrent to the behavior.
Attention-Deficit/Hyperactivity Disorder (ADHD) Characterized by inattentiveness, overactivity, and impulsiveness.
Risk Factors More boys than girls, Prenatal exposure to alcohol, tobacco, and lead, and severe malnutrition in early childhood increase the risk. Genetic link with abnormalities in catecholamine, and possibly serotonin metabolism. First degree relative increases the risk by 4-5 times
Attention-Deficit/Hyperactivity Disorder (ADHD) Essential Features Persistent pattern of inattention and/or hyperactivity and impulsivity more common than generally observed in children of the same age.
Nursing Actions in ADHD ENSURE SAFETY OF CLIENT AND OTHERS. Provide close supervision, give clear directions about acceptable behavior, give positive feedback, manage the environment (quiet, and free of distractions), Get child's full attention, simply instructions/directions, and break complex tasks into small steps. Allow breaks, but have a structured daily routine, minimize changes
Typical Behaviors of ADHD Cannot sit still, may dart around the room for no apparent purpose. Speech is unimpaired. Interrupts, blurts out answers, fails to pay attention to what is said, conversation topics jump, may appear immature or lag behind developmental milestones. Labile mood, verbal outbursts, temper tantrums, anxiety, frustration, and agitation are common.
Treatment of ADHD Methylphenidate (Ritalin), Amphetamine compounds (Adderall), Dextroamphetamine (Dexedrine), and pemoline (Cylert). Reduces hyperactivity, impulsivity, and mood lability and helps the child pay attention more appropriately. pemoline (Cylert) can cause liver damage so it is the last of the drugs to be prescribed
Side Effects of Stimulants Anorexia, weight loss, nausea, and irritability. The client should avoid caffeine, sugar, and chocolate, which may worsen these symptoms. Less common side effects include dizziness, dry mouth, blurred vision, and palpitations. The most common long-term problem with stimulants is the growth and weight suppression that occurs in some children. This can usually be prevented by taking “drug holidays”
Signs of Toxicity in Stimulants Severe agitation, cardiac dysrhythmias, combativeness, confusion, delirium, hallucinations, high body temperature, hyperactivity, hypertension, insomnia, irritability, nervousness, panic states, restlessness, tremors, seizures, coma, circulatory collapse, and death.
Signs of Toxicity in Amphetamines Psychosis, convulsions, stroke, cardiac arrest, and death.
Second Line Treatment of ADHD When stimulants fail, antidepressants are the next choice, specifically SNRIs
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