Autism spectrum disorder (ASD) (Sherpath)

These children ASD

prefer to be alone and do not engage in play with peers.

Narrow interests and repetitive (Clinical Manifestation)

behaviors are exhibited by a preoccupation with mechanical objects or numbers.

Which example demonstrates the cognitive concept of "islands of genius" as seen in ASD?

A child who can recite the complete daily area train schedules. A child who is able to recite large amounts of insignificant data, such as train schedules, is exhibiting "islands of genius."

The nurse teaches the parents of an autistic child how to implement structure in the home. Which is an example of structure by the parents?

Administering the child's medication every day after breakfast. Administering medications at the same time every day creates a consistent routine that creates a structured environment.

Which statement regarding ASD etiology and epidemiology is true?

Autism is more prevalent in boys than girls. Autism is three to four times more prevalent in boys than girls.

Epidemiology

Autism is three to four times higher in boys than girls and has no racial, ethnic, or social boundaries It has also been noted that girls with autism have more severe intellectual disability than boys.

Treatment plans for the autistic child also include:

Behavior management with a reward system Parent education Therapy; physical, occupational, speech, pet, art

The nurse assesses for:

Developmental delays Uneven development Medication side effects Loss of acquired abilities Bonding, anxiety, tension in the parent-child relationship Physical and emotional signs of possible abuse

The nurse is providing care for a child with ASD. The nurse rewards the child for following directions with stickers of the child's favorite cartoon character. Which goal of the treatment plan does this action best support?

Encourage concepts of identity, body image, and self-esteem Patients with ASD often have difficulty with identity, body image, self-esteem, and self-awareness. When the nurse rewards the patient with stickers, this encourages the concept of self-esteem.

Which are behaviors associated with autism spectrum disorder (ASD)?

Extreme resistance to change Children with ASD are very resistant to change or activities that occur outside of their regular schedules. Stereotypical repetitive speech Stereotypical repetitive speech, such as repeating a song's lyrics over and over, is a behavior associated with ASD. Fixation with particular objects Fixation with particular objects, such as a toy car and watching the wheels go round and round, is a behavior associated with ASD.

These patients may also exhibit:

Fascination with revolving objects (revolving ceiling fan, revolving door) Intense attention to how things work (turning a light switch on and off, opening and closing doors or drawers) Preoccupation with non-significant objects (buttons, zippers) Attachment to unusual objects (rubber band, piece of string) over typical objects (teddy bear, doll)

Which factors are most associated with the causes of ASD?

Genetic Genetic factors, such as Fragile X syndrome and tuberous sclerosis, have been associated with ASD. Metabolic Metabolic factors, such as oxidative stress and metabolic impairment, have been linked to ASD. Environmental Parental exposure to the chemicals thalidomide and valproic acid have been linked to increased risk of autism.

Symptoms of these behavioral problems include:

Hyperactivity Short attention span Impulsivity Aggressiveness Self-injurious behaviors Temper tantrums Abnormal eating patterns Disturbed sleeping patterns

Other goals include:

Increase the child's interest in reciprocal interactions and relationships. Foster the development of social skills. Facilitate the expression of appropriate emotional responses (e.g., empathy, shame, remorse, anger, pride, joy, and enthusiasm). Foster the development of language skills and reciprocal communication. Encourage participation in activities of daily living (ADLs) to develop psychomotor skills. Facilitate the development of attention, memory, cause and effect, reality testing, decision making, and problem solving. Encourage concepts of identity, self-awareness, body image, and self-esteem. Encourage use of self-control, impulse control, tolerance of frustration, and delayed gratification.

Which symptom in an infant may be most indicative of ASD?

Lack of eye contact Lack of eye contact, lack of facial expressions, and disinterest in others are signs of ASD in an infant.

The nurse informs an adolescent autistic patient that the use of cell phones is not permitted during the nursing assessment. Which social development skill is the nurse exhibiting?

Limit setting The nurse is exhibiting limit setting by asking the autistic patient not to use the cell phone.

Nursing Diagnosis for patient with Autism Risk for self-mutilation Impaired social interaction Impaired verbal communication Disturbed personal identity Risk of failure to develop Delayed growth and development

Nursing Diagnosis for Family of Autism Knowledge deficit Disabled family coping Disabled parental role Family processes, interrupted Self-care deficit

Which benefit have patients with ASD demonstrated after beginning medication therapy with an atypical antipsychotic?

Reduced harmful behaviors Patients with ASD have experienced a reduction in aggressive and harmful behaviors when taking an atypical antipsychotic.

Which type of treatment does the nurse facilitate for young children with ASD?

Referral to an early intervention program Young autistic children are typically referred to an early intervention program where they may receive care in nursery school, day treatment programs, and special education classes.

Which nursing diagnosis for the patient with ASD holds the highest priority for the nurse?

Risk for self-mutilation Risk for self-mutilation involves the autistic patient's safety and is of highest priority for the nurse.

A patient with ASD is demonstrating tantrums, self-injurious behavior, and aggression. Which medication would the nurse anticipate administering?

Risperidone Risperidone is an atypical antipsychotic that is used to treat symptoms of tantrums, tics, self-injurious behavior, and aggression in patients with ASD.

Which is the priority nursing goal that is included in plan of care for the patient with autism?

Safety Maintaining the safety of the child with autism and his or her family is the priority nursing goal in developing the plan of

Which family-oriented nursing diagnoses should the nurse include in the autistic patient's plan of care? Select all that apply.

Self-care deficit Self-care deficit is an important nursing diagnosis for the family of an autistic child, because the family will often ignore their own needs in lieu of caring for their autistic child. Disabled parental role The parental role in a family with an autistic child is often compromised and even disabled.

Sensory Problems

Sensory signals are disorganized causing abnormal responses, such as lack of fear in a dangerous situation or excessive fear in non-harmful situations. These children have a high pain threshold and may exhibit head banging or self-biting. also overly sensitive to odors, noise, light, and color, and may exhibit an exaggerated response to these. Eating foods that have a displeasing texture or wearing clothing that is scratchy may cause great distress.

Which class of antidepressant is most successful in the treatment of ASD symptoms?

Serotonin selective reuptake inhibitors (SSRIs) SSRIs are the type of antidepressant that has been most successful in treating ASD symptoms of depression and anxiety. SSRIs have allowed ASD patients to gain more tolerance of new situations.

Which factors are important for the nurse to assess in the patient with ASD? Select all that apply.

Signs of abuse Autistic patients are at high risk for abuse, so the nurse must carefully monitor the patient for signs of physical and emotional abuse. Bonding with parents Parents may have difficulty bonding with their autistic child, so it is important that the nurse assess the parent-child relationship. Medication side effects Most patients with ASD are prescribed antidepressants and/or atypical antipsychotics. It is important that the nurse closely monitor autistic patients for any medication side effects.

Which communication problems are common in patients with ASD?

Speaking in a monotone voicePatients with ASD may speak in a monotone voice with no inflection of emotion. Using a sing-song pitch and rhythmUsing a sing-song pitch and rhythm instead of a normal speaking voice is common in patients with ASD. Repeating song lyrics out of context during a conversationPatients with ASD may repeat lyrics to commercials or songs during conversations when the content of these lyrics do not parallel the conversation's content.

Communication Problems

Speech problems include abnormal: pitch intonation rhythm These patients may speak in a monotone, use an inappropriate sing-song pitch and rhythm, or use a questioning tone when speaking declarative sentences. Following simple commands, questions, and jokes is difficult, and sometimes these children speak their own idiosyncratic language that is only understood by those close to him or her. "islands of genius," where the patient may not be able to count change in a store but is able to solve complicated math formula

Behaviors associated with ASD include

Stereotypical repetitive speech Use of unusual objects Strict adherence to routines Fixation with particular objects Hypo- or hyper-reactivity to sensory input Extreme resistance to change

Which nursing action is most effective in improving the autistic patient's social skills?

Teaching the patient the appropriate time to feel shame versus joy Teaching the patient appropriate emotional responses helps the patient develop social skills.

Children with ASD also demonstrate stereotypic motor

activities, such as: Clapping/flapping of hands Spinning Rocking Swaying Walking on tiptoes Exhibiting odd postures Using strange hand movements

Arrested social skills (clinical manifestation)

are due to a lack of understanding about social cues. The child may withdraw and show low interest in others, or no reciprocity of attention.

Identical twins

are more likely to be affected than fraternal twins. In a family with one autistic child, the chance of having another autistic child is one in 20 (5 percent), which is much higher than in the non-affected population.

Speech and language delays (Clinical Manifestation)

exist with some children having no speech ability at all. Pitch and intonation are different with repetition of words or phrases. Facial expressions may be limited or flat.

Genetic causes

hat have been linked to ASD include rubella in the pregnant mother, tuberous sclerosis, and Fragile X syndrome

Possible metabolic factors include

oxidative stress and metabolic impairment. Other possible causes include encephalitis and untreated phenylketonuria (PKU).

Environmental factor

that could be a cause of ASD includes parental exposure to the chemicals thalidomide and valproic acid.