NUR400 Chapter 37

What are common examples of stimulants? (3)

- Methylphenidate (ritalin) - Amphetamine (Adderall) - LIsdexamfetamine (Vyvanse)

What are the common side effects associated with the use of stimulants?

- decreased appetite - nausea - sleep difficulties - transient headache

What age group is dexedrine appropriate for?

3 to 16 yo

What is the age range for use of adderall?

3+, extended release for >6 yo

What age group is guanfacine approved for?

6 to 17 years old

What is the average age of onset for tourrette syndrome?

7 years old

What age group could receive concerta as their stimulant?

> 6 years old

___________________ is characterized by persistent impairment in social communication and social interaction with others.

Autism

___________________ skills include language and literacy, money, time, number concepts, and self-direction.

Conceptual

What is the brand name for dextroamphetamine?

Dexedrine

What is the brand name for DEXMethylphenidate?

Focalin

The three core symptoms of ADHD are inattention, impulsiveness and __________________.

Hyperactivity

____________________ disorder is characterized by intrusive thoughts are difficult to dislodge

Obsessive Compulsive

School __________, when a child fears and refuses to attend school, is a behavioral manifestation of several different child psychiatric disorders.

Phobia

How many times a day will concerta be given?

QD

How often can adderall be given?

QD or BID

T/F: Caffeine increases the stimulant effects of methylphenidate

TRUE - gonna be like the energizer bunny

What category of drug atomoxetine in treatment of ADHD?

a second line non stimulant

What are common problems one may experience in childhood? Select all that apply. a. death and grieving b. bullying c. divorce d. physical illness e. bad grades

a, b, c, d

What is obsessive compulsive disorder?

anxiety due to intrusive thoughts or need to engage in ritualistic behavior

What is ADHD?

attention deficit hyperactivity disorder

Which of the following statements is true about tourette syndrome? a. phonic tics usually precede the development of motor tics b. the syndrome has periods of waxing and waning c. girls are more affected than boys d. antidepressants may be used to treat the disorder

b rationale: tourette syndrome is characterized by the motor and phonic tics that wax and wane. motor tics usually occur before phonic tics. boys are more likely affected and antipsychotics are used

which objective would be priority for a young child with ADHD who demonstrates intermittent head banging and hair pulling? a. facilitating sleep b. maintaining safety c. promoting body image d. increasing nutritional intake

b. maintaining safety

What is enuresis?

bed wetting

How do non-stimulant medications work?

block reuptake of norepinephrine

How is conduct disorder characterized?

by more serious violations of social norms, including aggressive behavior, destruction of property, and cruelty to animals

How is intellectual disability characterized?

by significant limitations in both intellectual function and in adaptive behavior that covers many everyday social and practical skills

Which instructions would the nurse include in parent teaching for their 6 year old child with autism spectrum disorder who exhibits frequent spinning and hand flapping behaviors? a. hold the child b. place the child in time out c. use another activity to distract the child d. determine the reason for the child's behavior

c

Which signs and symptoms would the nurse observe in a child with autism spectrum disorder? select all that apply. a. lack of appetite b. depressed mood c. repetitive activities d. inability to adapt to change e. lack of communication with others

c,d,e

Which priority assessment would the RN complete first when working with the family of a child diagnosed with ADHD? a. history of the disorder b. relationship with each other c. attitudes about the diagnosis d. understanding of the treatment regimen

c. attitudes about the diagnosis

Which action would the nurse take for a 9 year old child diagnosed with ADHD when teaching about personal safety? a. request that the child write at least 3 safety rules b. ask the child to verbalize as many safety rules as possible c. talk with the child about the importance of using a seat belt d. encourage the child to talk with other children about their opinions of safety rules

c. talk with the child about the importance of using a seat belt

What do low doses of stimulants help to do in the brain?

calm nerve signals

What is the mechanism of action of methylphenidate?

central nervous system and respiratory stimulation with weak sympathomimetic activity

What are the 3 skills affected in adaptive behavior?

conceptual, social, practical

What is the brand name for methylphenidate?

concerta

Which intervention would be most appropriate in an attempt to promote socialization for a child with ASD? a. encouraging participation in group activities b. providing minimal environmental stimulation c. holding and cuddling the child for short periods d. imitating and participating in the child's activities

d

Which disorder would the nurse clarify as neurodevelopmental? a. anxiety b. bipolar disorder c. scizophreniform disorder d. attention deficit/hyperactivity disorder

d. attention deficit/hyperactivity disorder

which overall outcome would the school nurse formulate for a 6 year old client with ADHD? a. developing language skills b. avoiding regressive behavior c. attending regular classes in school d. enhancing self-image as a worthy person

d. enhancing self image as a worthy person

How do stimulants work for ADHD?

decreases impulsivity and improves executive functioning

What is believed to be dysregulated within biological theories for etiology of ADHD?

dopamine and serotonin

What is does the biological theory believe the etiology is adhd is?

dysfunction of the dorsolateral prefrontal cortex

T/F: The diagnosis of intellectual disability is based on IQ alone.

false

T/F: Tourette disorder is a progressive condition, often worsening in adulthood.

false

T/F: atomoxetine is classified as a stimulant.

false

T/F: it is easier to diagnose psychiatric problems in children than adults

false

T/F: Autism and Asperger syndrome are two different disorders identified by characteristic manifestations that are distinct for both orders.

false autism and asperger syndrome were previously diagnosed as two separate disorders. however, because they overlap so much, the DSM-5 no longer considers them separate, but considers both ASD differentiated by language or intellectual impairment.

What are the risk factors of developing ADHD?

family hx of adhd substance use during pregnancy exposure to environmental toxins low birth weight brain injuries

What is encopresis?

fecal incontinence

What is the most common etiology of intellectual disability?

genetic syndromes

A patient is having a high fat meal, what medication should they AVOID taking? why?

guanfacine - high fat increases exposure to med

What are the side effects of adderall?

headache abdominal pain insomnia nausea decreased appetite tachycardia dizziness nervousness oral dryness

What are the contraindications for use of methylphenidate?

hypersensitivity, hyperthyroidism, psychosis, on an MAOI

What is the nursing management of enuresis?

limit fluid intake in evening desmopressin bell and pad

Where is atomextine metabolized in the body?

liver

What is tourette disorder?

multiple motor and phonic tics

What is the definition of autism spectrum disorder?

neurodevelopmental delays with or without intellectual disability

Are Autism and Asperger syndrome separate disorders?

no

What is separation anxiety disorder?

overwhelming fear of separation where it is developmentally inappropriate

What is oppositional defiant disorder?

persistent pattern of disobedience, argumentativeness, angry outburst, low tolerance for frustration, and tendency to blame others for misfortunes

What is the definition of ADHD?

persistent pattern of inattention, hyperactivity, easily distracted, and impulsiveness

How are asperger syndrome and autism differentiated?

presence of language or intellectual impairment

What are motor tics?

quick, jerky movements of the eyes, face, neck, and shoulders

What are the 2 most common behaviors seen with autism spectrum disorder?

repetitive behaviors and restricted interests

What are phonic tics?

repetitive throat clearing, grunting, or other noises or complex sounds such as words, parts of words, or possibly obscenities

What is always a priority in mental health nursing?

safety

What is the mechanism of action of atomoxetine?

selectively inhibits norepi resulting in therapeutic effect of increased attention span

What is included in the diagnostic criteria for intellectual disability?

significantly below average intelligence accompanied by impaired adaptive functioning and development delays

What should the nurse promote in a patient with ADHD?

sleeeeeeeep baby

What natural product increases the risk of serotonin syndrome when combined with methylphenidate?

st. john's wort

What type of medication is used as a first line treatment for ADHD?

stimulants

What are the adverse reactions of using atomoxetine?

suicidal ideation, liver toxicity, anaphylaxis

How is childhood schizophrenia diagnosed?

through the same criteria as adults

what are some examples of "highly restricted areas of interest"?

train schedules, fans, air conditioners, dogs

T/F: Adaptive behavior is composed of conceptual skills, social skills, and practical skills.

true

T/F: Buproprion (Wellbutrin) may be used to boost mood and treat ADHD symptoms

true

T/F: If a pediatric patient admits to thoughts of harm to self or others, the parents must be informed.

true

T/F: In autism spectrum disorder, impairment in communication is severe and affects both verbal and nonverbal communication.

true

T/F: The nurse should be working towards promoting an optimal level of functioning of a child with intellectual disability.

true

T/F: children are more likely to show suffering through behavior rather than expression of feelings.

true

T/F: if a patient is taking a medication that inhibits the CYP2D enzyme pathway like fluoxetine, the dose of atomoxetine needs to be increased.

true

T/F: patients with ASD may have highly restricted areas of interest.

true

What medication can be used off label to treat ADHD symptoms?

wellbutrin (it's me, I literally take it for this reason)