Care for Child With an Alteration in Behavior, Cognition, or Development

Agoraphobia

Extreme or irrational fear of entering open or crowded places, of leaving one's own home, or of being in places from which escape is difficult

The parents of an adolescent are concerned about his mental health and have brought the adolescent into the physician's office for an evaluation. Which statements by the parents indicate that the child may have a mental health disorder? Select all that apply. 1 "He has started sleeping for only 3 hours each night." 2 "He has lost 10 pounds over the last 4 months." 3 "He hangs out with the same kids he always has." 4 "He used to be a straight-A student and now he's bringing home Cs and Ds." 5 "He still enjoys playing a lot of baseball."

1.2.4. Altered sleep patterns, weight loss, and problems at school are commonly found in children with mental health disorders. There also may be alterations in friendships and changes in extracurricular activity participation

The nurse is assessing an adolescent who tells the nurse, "I have been using cocaine for a while now. At first, I would get high after smoking just once. But now I have had to smoke more and more to get the same effect." The nurse interprets the adolescent's statement as reflecting which situation? 1 withdrawal 2 tolerance 3 dependence 4 use disorder

2 The adolescent's statements reflect tolerance, which is the ability of body tissues to endure and adapt to continued or increased use of a substance; this dynamic means the drug user requires larger doses of the drug to produce the desired effect. NOT 4 A substance use disorder is the misuse of an addictive substance that changes the user's mental state. 3 Dependence is a compulsive need to use a substance for its satisfying or pleasurable effects. 1 Withdrawal refers to the physical and psychological symptoms that occur when the drug is no longer being used

What potential side effect of smoking crack should the nurse teach adolescents about to ensure their understanding of the drug's possible impact? 1 a rapid high followed by a slow letdown 2 a high that lasts hours 3 cardiac arrest 4 drop in temperature

3 Adolescents who smoke crack run the chance of having a cardiac arrest due to the rapid absorption of crack into the blood stream. NOT Cocaine usage and crack makes the body temperature rise (4), the high lasts a short amount of time usually 5 minutes (2), and the rapid high is followed by a rapid crash that resembles depression (1)

The football coach notices that one of the players has been more energetic and overly happy lately during practice. The player also got in fight with a teammate last week. The coach contacts the health care provider, concerned that the student is using anabolic steroids. What physical sign would the nurse advise the coach to be on the lookout for that would further validate the illicit drug use? 1 headaches 2 gynecomastia 3 fainting 4 extended periods of fatigue

2 Anabolic steroid use can cause periods of euphoria and decreased fatigue, not more fatigue. Gynecomastia is a common side effect of prolonged steroid use, as well as liver damage, HTN, psychotic episodes, and aggression. NOT 1.3. Headaches and fainting are not side effects of steroid use

While interviewing an adolescent client with depression, the client reveals to the nurse that he has considered hurting himself. Which response by the nurse would be most appropriate? 1 "Tell me exactly how you would hurt yourself." 2 "Why would you want to hurt yourself." 3 "Do your parents know that you want to hurt yourself?" 4 "Have you discussed this with anyone else?"

1 It is important to find out exactly how the adolescent is envisioning harming himself and to take measures to prevent an attempted suicide. NOT 2.3.4. Asking the adolescent why, if his parents know, or if he has discussed this with anyone else would elicit little information about the adolescent's thoughts

The nurse is conducting an examination of a boy with Tourette syndrome. Which finding should the nurse expect to observe? 1 toe walking 2 sudden, rapid stereotypical sounds 3 spinning and hand flapping 4 lack of eye contact

2 Sudden, rapid, stereotypical sounds are a hallmark finding with Tourette syndrome. NOT 1.3. Toe walking and unusual behaviors such as hand-flapping and spinning are indicative of ASD. 4 Lack of eye contact is associated with ASD but is also noted in children without a mental health disorder

Which sign or symptom suggests depression in a child? 1 repetitive behaviors 2 fear of leaving the house 3 somatic complaints and acting-out behavior 4 inability to sit still for extended periods of time

3 Signs of depression in children and adolescents include depressed or irritable mood, psychomotor agitation/slowness, changes in appetite and sleep, physical complaints, depressive themes, social withdrawal, intense anger or rage, anhedonia, acting-out behaviors, decreased ability to think, thoughts of and verbalizations about death, and specific stressors (e.g, a breakup with a boyfriend or girlfriend). NOT 4 The inability to sit still would be associated with ADHD. 1 Repetitive behaviors are associated with a child on the autism spectrum. 2 The fear of leaving home is associated with agoraphobia

The nurse is working with school-aged children who are having enuresis or encopresis. What will most likely be the first step in this child's treatment? 1 The child will be given medications. 2 The child will be taken to a therapist. 3 The child will have a complete physical exam. 4 The child will be given a strict daily schedule

3 The child with enuresis or encopresis may have a physiologic or psychological cause and may indicate a need for further exploration and treatment. A complete physical exam and assessment is done first to rule out any physical cause

What is an example of impaired adaptive functioning in an 8-year-old girl with a developmental disorder? 1 The child cannot correctly copy a phone number. 2 The child cannot properly dress herself. 3 The child's vision is fine but she is a poor reader. 4 The child cannot correctly copy a sentence.

2 A child with impaired adaptive functioning would not be able to dress herself properly, if at all. NOT 1.3.4. The inability to copy a phone number or sentence, or to read well, reflects learning disorders

Bulimia

Bulimia refers to a cycle of normal food intake, followed by binge-eating and then purging. Typically, the adolescent with bulimia remains at a near-normal weight. Complications of anorexia and bulimia include fluid and electrolyte imbalance, decreased blood volume, cardiac arrhythmias, esophagitis, rupture of the esophagus or stomach, tooth loss, and menstrual problems.

The nurse is caring for a 10-year-old girl with an anxiety disorder. During a physical examination, which physical finding would the nurse expect? 1 patches of hair loss 2 absence of nasal hair 3 dilated eyes 4 watery eyes

1 Patches of hair loss that occur with repetitive hair twisting or pulling are associated with anxiety. NOT 2.3.4. Watery, dilated eyes and the absence of nasal hair are often signs of substance abuse.

A nurse has been asked to conduct a presentation on human trafficking. When preparing the presentation, the nurse will include which factor(s) as placing individuals at risk? Select all that apply. 1 male gender, between 15 to 18 years of age 2 female gender, between 12 to 16 years of age 3 high level of education 4 history of child abuse (child mistreatment) 5 lack of adequate family support

Although trafficking can happen in any community and individuals of any age, race, gender, or nationality may be victims, women and children are the most frequent victims. Often poverty and lack of economic opportunities cause vulnerability and allow these individuals to be tricked and to become stuck in trafficking situations. Other risk factors that may lead to human trafficking include being a young girl (ages 12 to16 years old are at greatest risk), rural location, lack of education, disability, inadequate family support and protection, runaway or throwaway youth, migrant workers, and a history of childhood abuse (mistreatment). (2.4.5.)

The nurse has been working for several days with an adolescent who has anorexia nervosa. What is an indication that the adolescent is developing trust in the nurse? 1 The adolescent stating "You're the best nurse on the unit." 2 The adolescent telling the nurse purging occurs after each meal. 3 The adolescent stating the desire to eat again. 4 Saying which nurse's orders the adolescent will follow.

The adolescent with anorexia tends to have many fears and a high need for acceptance. Therefore, trust is difficult for this adolescent. Trust has to be gained from an adult before the adolescent can share confidences. 2Purging after every meal with anorexia is common and one of the goals of therapy is to stop the purging. It is often done in secret. When the adolescent has gained trust in the nurse then the adolescent will begin to share the number of times purging has been happening. NOT 1.4. When the adolescent is making statements such as liking one nurse more than another or following one nurse's instructions and not the others, this is manipulation. It is not healthy. 3 The adolescent stating a desire to eat again could be interpreted two ways. The adolescent could be getting healthier with therapy or it could also be seen as manipulation and a way to purge more often. Either way, it is not a sign that trust has developed

When teaching parents of a child with encopresis, what would the nurse stress? 1 Not punishing the child for encopresis 2 Importance of cleaning the child immediately after an accident occurs 3 Necessity for giving 4 to 6 tablespoons of bismuth subsalicylate per day 4 Need for keeping the child close to bathroom facilities at all times

1 Encopresis (inappropriate soiling of stool) is a symptom of an underlying stress or disease. It can be the manifestation of how the child expresses the trauma or depression that is occurring. The child needs therapy to determine the cause and to treat the problem. If a child is scolded or punished for encopresis or if more than normal attention is paid to the problem, the problem will worsen. NOT 3 Giving medications will not prevent the encopresis. 4 The proximity of the bathroom will not impact the situation, because with encopresis the child soils the underwear and does not go to the bathroom.

The nurse is examining a child with fetal alcohol spectrum disorder. Which assessment finding should the nurse expect? 1 macrocephaly 2 low nasal bridge with short upturned nose 3 clubbing of fingers 4 short philtrum with thick upper lip

2 Typical facial features in an infant with fetal alcohol spectrum disorder include a low nasal bridge with short upturned nose, flattened midface, and a long philtrum (NOT short) with narrow upper lip. NOT 1 Microcephaly rather than macrocephaly is associated with fetal alcohol spectrum disorder. 3 Clubbing of fingers is associated with chronic hypoxia

Fragile X Syndrome (FXS)

A genetic condition causing intellectual disability. FXS causes mild to severe intellectual disability. It affects both M&F, but females usually have milder symptoms. Symptoms include delays in talking, anxiety, and hyperactive behavior. Some people have seizures. Physical features might include large ears, a long face, a prominent jaw and forehead, and flat feet. Therapy can be used to treat learning disabilities. Medications may be used to treat anxiety and mood disorders.

Medical child abuse

Historically termed Munchausen syndrome by proxy. It is a type of child abuse in which the parent creates physical and/or psychological symptoms of illness or impairment in the child. The adult meets his or her own psychological needs by having an ill child. Medical child abuse is difficult to detect and may remain hidden for years. In most cases, the biologic mother is the perpetrator. Therapeutic management focuses on ensuring the safety and well-being of the child, as well as providing psychotherapy for the perpetrator.

An adolescent is being seen in the local clinic for obesity problems. The nurse realizes that which factor would not play a role in this eating disorder? 1 having obese parents 2 eating fast food frequently 3 having positive self-esteem 4 skipping meals and late night eating

Obesity in children usually has some commonalities among the factors affecting the child and encouraging overeating. Obese children are frequently products of obese parents who do not set good examples for the children by eating fast food or non-nutritious foods, encourage eating as a reward, or giving food to make the child feel better temporarily. Additionally, if parents do not discourage late-night eating (when calories will not be burned and will turn into fat) and don't discourage skipping meals, they are setting the child up for obesity. 3 Promoting a positive self-image is not one of the factors that plays a role in obesity

The nurse is discussing the treatment for a child with attention deficit hyperactivity disorder (ADHD) with a group of school nurses. What would be an appropriate learning setting for a child with ADHD? 1 a classroom with a plan of study that is followed each day 2 a classroom with windows facing a playground 3 a classroom in which children self-select their activities 4 a classroom with tables and chairs rather than individual desks

1 For the child with ADHD, the learning situations should be structured so that the child has minimal distractions and a supportive teacher. Special arrangements can be made to provide an educational atmosphere that is supportive for the child without the need for the child to leave the classroom. NOT 2 Having the child with ADHD face the playground would provide the child with too much distraction. 3 Having the child with ADHD select his or her own activities or placing the child at tables instead of an individual desk means the child would not stay on task. Giving the child too many choices only serves to confuse the child and leads to increasing hyperactivity and loss of control.

A family includes a 9-year-old child. The nurse suspects that the family has caregiver-fabricated illness (formerly Munchausen syndrome by proxy). Which nursing intervention is best when assessing the child and family in the pediatrician's office? 1 Ask to speak to the child separate from the family. 2 Turn off the video surveillance in the room. 3 Keep both parents in the room at all times. 4 Ask the parents together how the child is doing.

1 In caregiver-fabricated illness (formerly Munchausen syndrome by proxy), parents report prolonged, unexplained illnesses for the child. Even though the child has been seen for medical treatment, the health issues are never resolved. The parent shows a lack of concern about the symptoms and the illnesses. Symptoms usually occur when no one else is present. The nurse should speak to the child alone, video and document interactions, contact the medical team, and contact protection services for the child if needed

Which sign or symptom suggests that a 5-year-old boy who does not maintain eye contact or speak may have autism spectrum disorder (ASD)? 1 The child constantly opens and closes his hands. 2 The child is highly active and inattentive. 3 The child has a slight decrease in head circumference. 4 The child has a long face and prominent jaw

1 Repetitive motor mannerisms such as constantly opening and closing the hands are a typical behavior pattern for ASD. NOT 2 A high level of activity and inattentiveness are typical symptoms of intellectual (mental) disability. 3 Decrease in head circumference suggests malnutrition or decelerating brain growth. 4 A long face and prominent jaw are symptoms of Fragile X syndrome.

In collecting data on a 7-year-old child with a possible diagnosis of school phobia, the nurse directs questions related to the following topics. Which would most likely be a cause of the child having school phobia? 1 The child may have a fear of being separated from the parent. 2 The child may be a poor student and be afraid of failing grades. 3 The child may have a language barrier. 4 The child may be bored and feels more intellectually stimulated at home.

1 School-phobic children may have a strong attachment to one parent, usually the mother, and they fear separation from that parent, perhaps because of anxiety about losing her or him while away from home. NOT 2 Being a poor student and worrying about grades would be more common in the later school age and adolescence. 3 A child may be anxious about language but that is generally not enough to cause phobias. 4 If the child is bored at school the parents should ask to meet the teacher and define the child's needs. Many children need extra stimulation but that is not the same as having a phobia

The nurse is caring for a girl with anorexia who has been hospitalized with unstable vital signs and food refusal. The girl requires enteral nutrition. The nurse is alert for which complications that signal refeeding syndrome? 1 cardiac arrhythmias, confusion, seizures 2 orthostatic hypotension and hypothermia 3 hypothermia and irregular pulse 4 bradycardia with ectopy and seizures

1 The nurse should be aware that rapid nutritional replacement in the severely malnourished can lead to refeeding syndrome. Refeeding syndrome is characterized by cardiovascular, hematologic, and neurologic complications such as cardiac arrhythmias, confusion, and seizures. NOT 2.3.4. Orthostatic hypotension, hypertension, and irregular and decreased pulses are complications of anorexia but do not characterize refeeding syndrome

The nurse is caring for a 7-year-old girl with conduct disorder. The child is very aggressive and at risk for self-harm. To promote the child's adaptive and social skills, the nurse refers the family to a therapist who specializes in which type of therapy? 1 milieu therapy 2 play therapy 3 cognitive therapy 4 family therapy

1 The therapeutic goal of milieu therapy is to promote the child's adaptive and social skills. It is a safe and supportive environment for children who are at risk for self-harm, very ill, or very aggressive. NOT 2 Play therapy encourages, designed to change emotional status, children to act out feelings of sadness, fear, hostility, or anger. 3 Cognitive therapy teaches children to change their reactions so that automatic negative thought patterns are replaced with healthier ones. 4 Family therapy explores the emotional issues of the child and their effects on family members (helps the family to focus in more constructive ways.)

A parent brings a preschooler to the behavioral clinic for evaluation. Upon entering the room, the child appears not to notice the nurse's presence. The child screams upon the nurse's touch. What condition should the nurse suspect? 1 learning disability 2 autism spectrum disorder 3 Down syndrome 4 Findings are normal for a preschooler.

2 ASD is characterized by markedly abnormal or impaired development in social interaction and communication. Social impairment is sustained and includes such things as poor eye contact, not liking to be touched, and preferring solitary activities. NOT 3 The findings are not indicative of Down syndrome or a learning disability. Down syndrome children are usually very friendly and like to be hugged and touched. 1 A child with a learning disability does not have problems with socialization. 4 These symptoms are not normal findings in preschoolers. Preschoolers are very interested in their surroundings and very interactive

A nurse in a residential foster home is caring for a 17-year-old client with oppositional defiant disorder. The client is using profanity and refusing to complete assigned chores. The nurse reminds the client that there are only 5 minutes in which to finish the chores. The client throws a dirty plate at the wall. How should the nurse respond? 1 "You only have a few minutes to complete your chores." 2 "I am sorry you are feeling so angry tonight but you must still complete your chores." 3 "I find your language offensive and you need to stop talking that way." 4 "If you calm down right now I will give you a few extra minutes to complete your chores."

2 An adolescent with an oppositional defiant disorder can frequently demonstrate active defiance, has frequent anger and is noncompliant with adult requests or limits. In this situation the nurse's goal is to clearly but empathetically explain the rules and firmly adhere to them. NOT 1 Telling the adolescent there are only a few minutes to complete the chores does not exhibit empathy. 3 Nor does the statement "I find your language offensive." It also does not address the rules. 4 Letting the adolescent have a few extra minutes only reinforces the negative behavior and does not respect the rules of the facility

Parents of a 36-month-old child confide in the clinic nurse that their child does not speak and spends hours staring at their ceiling fan. They are worried that their child may have autism spectrum disorder. Which question would be important for the nurse to ask the parents? 1 "Does your child have siblings?" 2 "Does your child come and hug you or seek comfort from you?" 3 "Do you have trouble keeping child care providers for your child?" 4 "Does your child already attend therapies such as speech therapy?"

2 Children with ASD lack communication and social skills. These children often will not seek comfort, make eye contact, or develop peer relationships. It is important during the health history for the nurse to focus on the findings the parents are presenting and not on extra information that may or may not be helpful

A 6-year-old child has been recently diagnosed with mild to moderate cognitive delay. The parent is tearful and questions if the child will need to attend special schooling. What response by the nurse is indicated? 1 "All children with mild cognitive delay are able to attend schooling and do not require placement in a special needs class." 2 "Children with cognitive delay are able to attend regular public school and are provided accommodations based on learning needs." 3 "Private schools do not accept children with a cognitive delay because it is costly to maintain a special needs program." 4 "Your child will likely be fine in public schools now but will need more specialized programming in high school."

2 Most children with cognitive and developmental concerns are able to attend public schools because they are provided with an individualized education plan (IEP). The IEP is a legal document that details the personalized learning needs and goals for a child with a disability as defined by the American Disability Act. K-12 public schools receive funding and support to accommodate the needs of a child with an IEP. Children are evaluated and placed on the appropriate grade level and classes that meet their specific needs. Some children with mild cognitive delay, are placed in regular classes. However, depending on the results of their evaluation and IEP, some children with mild cognitive delay may be enrolled in both regular class and special needs class as a supplemental class to meet their needs. Yearly evaluation is conducted for students with IEPs. Depending on the recommendations listed in the student's IEP a child with mild cognitive delay may or may not need specialized programming in high school. Some private schools accept children with mild cognitive delay and/or with special needs if the school is able to meet the type of need that the student has. However, private schools do not receive funding and are not required to provide free appropriate education or an IEP. Therefore, private schools have the choice whether to accept or deny enrollment of students with cognitive delays and special needs

A young parent brings the school-aged child to the office for a sports physical examination. During the appointment, the parent informs the nurse about being worried because the child does not like school and does not seem to be reading, writing, or spelling as well as others in the class. The parent adds that the child struggles to get organized and to manage time. What condition does the nurse suspect? 1 autism spectrum disorder 2 learning disorder 3 Down syndrome 4 Asperger syndrome

2 The child appears to have a learning disorder based on challenges with reading, spelling, and writing as well as being organized and managing time. Other findings consistent with a learning disorder include delayed language development and difficulty discriminating among sounds. NOT 1 ASD represents a range of disorders characterized by markedly abnormal or impaired development in social interaction and communication. 3 Down syndrome is a condition in which extra genetic material causes delays in how a child develops, both physically and cognitively. 4 Asperger syndrome is a type of ASD

A mother is telling the school nurse about her concerns regarding her 13-year-old daughter, who is experiencing headaches. Her grades have dropped, and she is sleeping late and going to bed early every night. The nurse advises the mother that the first priority should be to: 1 discuss the situation with her teacher. 2 schedule an immediate history and physical examination. 3 ask the school psychologist to do psychometric testing. 4 call for an appointment with a psychologist.

2 The first step is to conduct a physical examination to rule out or identify illnesses or physical problems that might cause depression. Once any physical causes have been ruled out, the health care team can determine the most appropriate approach to assess the girl's symptoms

The nurse is caring for an adolescent diagnosed with anorexia nervosa. Which education will the nurse include in the client's discharge teaching? 1 appropriate exercise routines 2 methods for desensitization 3 referrals to counseling services 4 proper administration of phenelzine

3 Adolescents with eating disorders need to increase self-esteem or a feeling that they have control over their life. This can be achieved through extensive counseling services, which should be scheduled for this client prior to discharge. NOT 1 The client needs to be nutritionally stable before participating in exercise activities. 2 Desensitization is not a method of treatment used for anorexia. It is used to diminish emotional responsiveness to a stimulus through repeated exposure. 4 Phenelzine, a MAOI, is not used to treat anorexia. It is used to treat depression. SSRIs and antipsychotics are typically used to treat clients with anorexia nervosa

The nurse suspects sexual maltreatment in a 10-year-old girl. The nurse would assess which primary finding to help make this determination? 1 regular menses 2 Tanner stage 4 development 3 vaginal discharge 4 decreased skin turgor

3 An inspection of the external genitalia should be done at each yearly health assessment. An assessment for vaginal discharge or irritation should be done if the girl reports these problems or if sexual maltreatment is suspected. A vaginal discharge that suggests infection or a fourchette (thin fold of skin at the back of the vulva) tear in a young girl may be an indication of sexual maltreatment. In the adolescent, these signs can be an indication of rape. NOT 2 The 10-year-old girl should be in Tanner stage 2. 4 Decreased skin turgor would be an indication of dehydration, which may be related to a variety of reasons but not necessarily to sexual maltreatment

A nurse is assessing a little boy who has been diagnosed with Tourette syndrome. Which finding would the nurse expect to see? 1 Toe walking 2 Lack of eye contact 3 Speaks sudden, fast phrases out of context 4 Spinning and hand-flapping

3 In Tourette syndrome, children have uncontrolled vocal tics. NOT 1.4. Toe walking and hand flapping/spinning is seen more in children with autism spectrum disorder. 2 Lack of eye contact can also be found in children with autism spectrum disorder, but also can be normal in kids.

Parents of a school-age child have begun a program of therapy that includes giving the child a token each time the child follows directions. Which theoretical framework provides the background for such a program? 1 psychodynamic theory 2 systems theory 3 behavioral theory 4 token economy theory

3 Reinforcing behaviors with rewards reflects a basic principle of behavioral therapy. This process reinforces the desired behaviors by replacing inappropriate behaviors with positive behaviors. NOT 1 Psychodynamic theory involves in-depth talk theory based on psychoanalysis. 2 Systems theory is looking at all systems to see how they work together to produce a result. This work involves the study of the mind, body and spirit. 4 A token economy allows for tokens to be accumulated for good behavior and then exchanged for a meaningful object or privilege.

A nurse is caring for a 17-year-old female client with bulimia. Which complication of this disease may the nurse see in this child? 1 Partial paralysis 2 Hernia 3 Severe acne 4 Menstrual problems

4 Bulimia is an eating disorder that has assessment findings of menstrual problems, esophagitis, cardiac arrhythmias, and fluid and electrolyte imbalance NOT 1.2.3. Paralysis, hernia, and acne are not distinguishing features of bulimia.

Adaptive functioning

A person's ability to carry out daily tasks that allow her to be independent. How effectively individuals cope with ordinary life demands and how capable they are of living independently and abiding by community standards

Milieu therapy

A specially structured setting designed to promote the child's adaptive and social skills. A safe and supportive environment for those at risk for self-harm or those who are very ill or very aggressive. Individual therapy

The nurse is working closely with the parent of a 6-year-old client who was just diagnosed with attention deficit/hyperactivity disorder (ADHD). Which methods used in behavior modification would be appropriate for this child? Select all that apply. 1 Provide a structured environment 2 Give medication only when needed 3 Be fair but firm, and stick to rules 4 Give short and clear explanations 5 Wait a few days to punish

A variety of treatments are used in the therapeutic management of ADHD. Behavior modification may help treat the varying causes, because the cause of the disorder is unknown. 1 A quiet, structured environment decreases stimulation for this child. 3.4. These children have trouble paying attention and focusing. Therefore, short goals and being firm add to the structured environment NOT 2 Medication should be followed as prescribed to avoid behavior changes and side effects.

The nurse is recording vital signs in the client diagnosed with complications of anorexia nervosa. Which findings are consistent with the condition? Select all that apply. 1 hyperthermia 2 orthostatic hypotension 3 weak pulse 4 hypertension 5 hypothermia

Anorexia nervosa is a condition most commonly seen in adolescents. In this condition, the individual is obsessed with body weight. There is a noted loss of weight. 2.3.5. The vital signs frequently display orthostatic hypotension, irregular and decreased pulse, or hypothermia

A 17-year-old child has been admitted with complications of anorexia nervosa. What diagnostic tests can be anticipated in the plan of care/treatment? Select all that apply. 1 CBC 2 MRI 3 CT scan 4 metabolic panel 5 CXR

Anorexia nervosa is characterized by dramatic weight loss as a result of decreased food intake and sharply increased physical exercise. Complications of anorexia include fluid and electrolyte imbalance, decreased blood volume, cardiac arrhythmia, esophagitis, rupture of the esophagus or stomach, tooth loss, and menstrual problems. 4 A metabolic panel would highlight alterations in electrolyte status. Electrolyte imbalances are also associated with cardiac arrhythmia. 1 Reduced dietary intake may result in anemia. This will be noted in the hemoglobin level. An alteration in blood volume will be reflected in the hematocrit level

Dialectical behavioral therapy

Group and individual sessions to treat chronic suicidal thoughts in borderline personality disorder. Individuals learn responsibility for their problems and better deal with negative emotions

Philtrum

Rectangular area from under the nose to the midline of the upper lip

Refeeding syndrome

Refeeding syndrome can be defined as the potentially fatal shifts in fluids and electrolytes that may occur in malnourished patients receiving artificial refeeding (whether enterally or parenterally). These shifts result from hormonal and metabolic changes and may cause serious clinical complications

Somatic complaints

Somatic symptom disorder involves a person having a significant focus on physical symptoms, such as pain, weakness or shortness of breath, that results in major distress and/or problems functioning. The individual has excessive thoughts, feelings and behaviors relating to the physical symptoms