children

Question 1

People with ADHD show ______

Answer 1

a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development

Question 2

List at least 5 ADHD symptoms

Answer 2

• Failure to give close attention to details or makes careless mistakes in school work, work, or other activities
• Often avoids tasks requiring mental effort
• Fidgets with hands/feet or squirms in seat
• Runs and climbs excessively (restlessness)
• Interrupts or intrudes on others
• Does NOT seem to listen

Question 3

Factors of ADHD

Answer 3

1. Genetic
2. Congenital brain damages
3. Env– Maternal cigarette smoking and alcohol usage during pregnancy, preschoolers who are exposed to high levels of lead

Question 4

Medical Management of ADHD

Answer 4

Pharmacotherapy (mostly stimulants)

• Ritalin (methylphenidate)
• Dexedrine (dextroamphetamine)
• Adderall (amphetamine)
• Focalin (dexmethylphenidate)

Question 5

Nursing interventions of ADHD (at least 5)

Answer 5

1. Decrease risks for injury
   - Ensure safe environment
   - Make corrective feedback as specific as possible (Don’t jump down the stairs. Walk one step at a time).
2. Management of medication side effects
   Insomnia: earlier dosing, co administer clonidine (light sedative) or trazodone at bedtime
   Reduced appetite: morning dosing, use Focalin (result in less of this effect), ensuring that the child eats healthy meals
   Stomachache: Give medication with food
   Mild dysphoria: Switch medication or add antidepressants as ordered
   Headache, Lethargy, sedation, impaired concentration: Reduce dose
3. Enhance performance and social interactions
   - Identify factors aggravating or alleviating the client’s performance
   - Let the client repeat instructions before doing the task
   - Provide positive feedback after completion of the task

Question 6

Factors of conduct disorder (at least 5)

Answer 6

• Harsh and punitive parenting (physical and verbal aggression)
• Family dysfunction and chaotic home conditions
• Parents’ psychopathology (eg. Psychotic disorder, substance-related disorder)
• Child abuse and neglect
• Violent video game playing
• Decreased norepinephrine functioning

Question 7

Description of conduct disorder

Answer 7

Persistent failure to control behaviour within socially defined rules

Question 8

Clinical manifestations’ criteria

Answer 8

Manifest at least 3 of the mentioned symptoms in the past 12 months

Question 9

Clinical manifestations of conduct disorder

Answer 9

1. Aggression to People and Animals
   - Bully, threaten or intimidate others
   - Often initiate physical fights
   force someone into undesirable social activities
   - Physically cruel to people and animals
   - Commit crimes (mugging, purse snatching, extortion, armed robbery)
2. Destruction of Property
   Deliberately engage in fire setting or destroying others’ properties
3. Deceitfulness or theft
   - Steal items or break into someone else’s properties
   - Con or lie to others
4. Serious violation of rules
   - Often plays truant
5. Age < 18 years (May lead to anti social personality disorder)

Question 10

Medical treatment of conduct disorders

Answer 10

• Treat comorbid substance abuse first
• Behavioural modification
• Structured children’s activities and curfew enforcement
• Parental communication techniques
• Pharmacological interventions:
  Dexedrine
  Ritalin
  Wellbutrin
  Prozac

Question 11

Nursing interventions of conduct disorders (At least 5)

Answer 11

• Limit setting on undesirable behaviours
• Validate the client’s feelings of frustration but remain firm
• Structure a daily schedule such as getting up, going to bed, etc
• Assess threats or suicidal risk seriously (impulsive)
• Encourage the client to verbalise his/her feelings
• Role model appropriate communication and social skills
• Gradually introduce other clients into interaction with the client who has conduct disorder🡪 support

Question 12

Clinical manifestations of autistic spectrum disorder

Answer 12

1. Qualitative impairment in social interaction
   - Poor use of non-verbal behaviours (eye contact, facial expression, gesture)
   - Failure to develop peer relationships appropriate to developmental level
   - A lack of seeking to share enjoyment, interests, or achievement with others
2. Qualitative impairment in communication
   - Delay in, or lack of the development of spoken language
   - Stereotyped and repetitive use of language
3. Restricted repetitive and stereotyped patterns of behaviour, interests, and activities
   - Preoccupation with one or more interests such as dates, phone numbers and timetables (abnormal in intensity or focus)
   - Stereotyped repetitive mannerisms such as clapping rocking or twisting

Question 13

Medical intervention of ASD

Answer 13

Medication for hyperactivity such as Ritalin and Lexapro

Question 14

Nursing intervention of ASD

Answer 14

• Language and academic interventions
• Echolalia: The autistic child repeat sounds or words spoken by others.
• Behavioural modifications to reduce disruptive behaviours
• Education programme for parents (esp concept of behavioural modification)
• Parent support group- high risk of caregiver stress