Human Development Review – Flashcards
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What are some behavior warning signs of developmental delay?
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Unfocused Eye-Contact Frustration Aggressive Violent Does not seek love Stares into space, rocks body, or talks to self
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What are some gross motor warning signs of developmental delay?
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Stiff extremities Floppy/Limp Body Uses one side of body more than another Clumsy Manner
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What are some vision warning signs of developmental delay?
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Following objects Rubs eyes Eye contact/focus Closes one eye when looking at distant objects Crossed Eyes Brings objects close to see
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What are some hearing warning signs of developmental delay?
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Voice Response Startle Ear Size Sounds/word development
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True/False: Developmental Screening is the initial screening, not a diagnosis.
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True
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True/False: Developmental evaluation is when the patient is diagnosed.
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True
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Fails to give close attention to details Fails to listen when spoken to directly Doesn't follow through on instructions trouble organizing easily distracted forgetful
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Inattention
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Fidgets or taps hands, feet, squirms in seat Runs about or climbs when not appropriate unable to play quietly has trouble waiting his.her turn interrupts/intrudes
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Hyperactivity
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In order to be diagnosed with ADHD, the patient must...
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-have symptoms present before age 12 -have symptoms in two or settings -evidence that symptoms interferes with school, social, or work functioning -Symptoms not better explained by another mental disorder
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What are the stimulant medications used for ADHD?
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Ritalin Dexedrine Adderall
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What is the non-stimulant medication used for ADHD?
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Strattera
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For ADHD medication, how long may it take for a response to the medication?
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up to 6 weeks
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When is the onset of austim spectrum disorder typically?
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by 2 years old
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Which exemplar consists of persistent deficits in social communication and social interaction across multiple contexts, restricted, repetitive patterns of behavior, interests, or activites?
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Autism
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What are the warning signs of autism?
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Babbling be 12 months Gesturing (pointing bye-bye) by 12 months Saying single words by 16 months Saying two word spontaneous phrases by 14 months (not just echoing) Losing any language or social skills at any age Regression
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What is stimming?
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Children with autism usually do this to decrease stress, do not stop them unless they are harming themselves.
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Which exemplar usually presents as withdrawn, lack of empathy?
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Autism
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Which exemplar? Does not startle at loud noises, may find normal normal noises painful and hold hands over ears.
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Autism
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Which exemplar? Cannot start or maintain a social interaction Communication with gestures instead of words Develops language slowly or not at all Does not adjust gaze to look at objects that others are looking at Does not refer to self correctly, for example says "you want water" when the child means "I want water"
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Autism
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What can the nurse to make a child with autism more comfortable a the hospital?
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Explain everything to them Orient them Use plain simple language Ask "easy to answer" questions Routine
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What is the permanent cessation of menstruation due to decrease in estrogen production and loss of ovarian function?
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Menopause
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Menstrual problems Increase in irritability Migraines Fatigue Poor Concentration Loss of libido Inability to multi-task
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Perimenopause
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What are some interventions for perimenopause?
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exercise increase sleep decrease alcohol increase calcium
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For menopause, estrogen and progesterone levels decline, which causes...
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FSH and LH increase because of the lack of ovarian hormone feedback.
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What causes symptoms associated with menopause?
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High levels of pituitary hormones Low Levels of ovarian hormones
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Absence of menstruation for one year Increased FSH blood test
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Diagnosis of Menopause
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What are some other causes of menopause?
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Chemotherapy and radiation Surgery for removal of female parts Premature Ovarian Insufficiency (POI)
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Occurs when the ovaries stop producing hormones and releasing eggs prior to the age of 40
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Premature Ovarian Insufficiency (POI)
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True/False: If you do not have a uterus, you need to take progesterone and estrogen.
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True
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True/False: If you do not have any female parts, you do not get progesterone.
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True
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What is the supplement of estrogen or progesterone or combination of both?
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Hormone Replacement Therapy (HRT)
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True/False: Hormone replacement therapy can be administered by pill, transdermal patch, or injection.
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True
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What are the risks associated with HRT?
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Breast Cancer blood Clots stroke
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What are some psychosocial aspects of menopause?
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Sense of loss Decrease in self-esteem Depression
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When does aging begin?
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At Conception
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What it the age for being old?
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There is no specific age
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Recent memory loss Difficulty performing familiar tasks Language Disorientation to time/place Poor judgement Misplacing things Mood Changes Personality changes
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Dementia
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Most common cause of dementia Affects approximately 5.2 million people in US Irreversible, progressive brain disease Plaques accumulate and kill brain cells Affected brain regions everntually shrink
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Alzheimer's Disease
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What is this tool called? Assesses functional status in a measurement of the patient's ability to perform activities of daily living independently.
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Katz Index of Independence in Activities of Daily Living
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What is this tool called? Useful for clarifying how a person is functioning at the present time and for identifying improvement or deterioration over time.
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The Lawton Instrumental Activities of Daily Living Scale (IADL)
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What is this tool called? This tool screens for primary prevention of falls and is integral in a post-fall assessment for the secondary prevention of falls.
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The Hendrich II Fall Risk Model
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What is this tool called? A screening tool used to identify older adults (>65 years) who are malnourished or at risk of malnutrition.
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Mini-Nutritional Assessment
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Symptoms of ADHD usually appear by this age.
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7
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Affects approximately 1/3 of older people.
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Depression
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Degenerative bone disorder
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Osteoporosis
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This communication impairment is a clinical manifestation of autism spectrum disorder
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Verbal
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Most common chronic behavioral disorder that emerges during childhood.
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ADHD
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Clinical manifestation of ADHD
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Inattention
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Enlargement of this gland is an age-related change sometimes present in males.
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Prostate
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Set of skills that most children do at certain ages
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Milestones
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Referred to as the "change of life"
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Menopause
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Oldest psychosocial theory of aging
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Disengagement Theory
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Sudden drop in this hormone is the main reason for hot flashes
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Estrogen
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May be affected by stimulant medication
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Appetite
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Discrimination against people because of increasing age
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Ageism
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With stimulant ADHD medications, when is the appropriate time to give the medication?
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Give in the morning No later than 4/5pm
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With ADHD medications, what test needs to be ordered?
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Liver Function tests
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A nurse in a school health clinic is performing an assessment on an adolescent. Which of the following should alert the nurse to a possible mood disorder? (Select all that apply.) 1. Psychomotor retardation 2. Impulsiveness 3. Changes in sleeping patterns 4. Difficulty paying attention 5. Irritability
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1. Psychomotor retardation 3. Changes in sleeping patterns 5. Irritability Increased sleeping, psychomotor retardation, and irritability are all findings consistent with depression. Impulsiveness and difficulty paying attention are more likely to be signs of attention deficit hyperactivity disorder.
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A 5 year old is brought to a mental health agency by his mother. The mother says the child is unable to sit through meals and is so easily distracted that he cannot even sit through a 30-min cartoon video. His kindergarten teacher reports difficulty following directions and attending to one task. The nurse should recognize that these findings are consistent with A. mental retardation. B. oppositional defiant disorder. C. posttraumatic stress disorder. D. attention deficit hyperactivity disorder.
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D. attention deficit hyperactivity disorder ADHD is characterized by constant movement, distractibility, and difficulty focusing on tasks. Mental retardation is evidence by below average intellectual functioning as measured by an IQ less than 70. If oppositional defiant disorder were the problem, the child would be argumentative and push the limits of parental authority. PTSD is characterized by aggressiveness, somatic reports, and irritability.
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A nurse is assessing a 4-year-old child for signs of autism. The nurse should be alert for A. constant talking and impulsive behavior. B. poor language and interpersonal skills. C. destructiveness and history of irritability and hostility. D. night terrors and reports of somatic problems.
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B. poor language and interpersonal skills. Children with autism have difficulty learning language skills and may fail to develop interpersonal relationships. Constant talking and impulsive behavior are among the signs of ADHD. Destructiveness, irritability, and hostility relate to conduct disorder. Night terrors and somatic problems relate to PTSD.
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A nurse is reviewing methods of home behavior modification that a mother uses for her 7-yearold daughter who has ADHD when she invites other children in the home for group play. Which of the following statements by the mother indicates a need for clarification? A. "I will use a calm, firm, respectful manner with my daughter." B. "I will plan quiet, low-energy activities such as painting with watercolors." C. "I'll let my daughter plan her activities for the day." D. "I'll give my daughter positive comments about appropriate behavior."
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A. "I will use a calm, firm, respectful manner with my daughter." Children with ADHD do better with activities that involve physical exertion and energy expenditure
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Which of the following is an example of a central nervous system stimulant that can be prescribed for children who have ADHD? A. Fluoxetine (Prozac) B. Methylphenidate (Concerta, Ritalin) C. Atomoxetine (Strattera) D. Amitriptyline (Elavil)
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B. Methylphenidate (Concerta, Ritalin) Methylphenidate is a central nervous system stimulant that can be prescribed for children who have ADHD. Fluoxetine is a SSRI. Atomoxetine is a norepinephrine selective reuptake inhibitor. Amitriptyline is a TCA.
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A nurse is caring for a school-age child who recently began a prescription for atomoxetine (Strattera). For which of the following possible complications should the nurse monitor the child? A. Renal toxicity B. Liver damage C. Seizure activity D. Adrenal insufficiency
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B. Liver damage Liver damage may occur while taking atomoxetine. The nurse should monitor for signs such as jaundice, upper abdominal tenderness, darkening of urine, and elevated liver enzymes. Renal toxicity, seizure activity, and adrenal insufficiency are not complications expected when taking atomoxetine.
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A nurse is caring for a school-age child who has just been prescribed methylphenidate (Concerta) to treat ADHD. Which of the following should the nurse teach the client and family about this medication? A. Apply the patch once daily at bedtime. B. Take oral medication once daily in the morning. C. Take oral medication early in the morning and again at bedtime. D. Apply the patch on awakening and remove at bedtime.
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B. Take oral medication once daily in the morning Concerta is a long-acting formulation of methylphenidate that should be taken once daily in the morning. A long-acting methylphenidate (Daytrana) transdermal patch is available, which should be put on in the morning and removed after no more than 9 hours each day. Short-acting methylphenidate (Ritalin) is taken orally 2 or 3 times daily. The last dose is taken no later than late afternoon or early evening so as not to interfere with the child's sleep.
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A nurse is providing teaching to the parent of a child who has attention-deficit/hyperactivity disorder. The nurse should include which of the following as a characteristic of impulsivity? A. Loses things B. Frequently interrupts C. Is easily distracted D. Talks excessively
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B. Frequently interrupts A. INCORRECT: Losing things is a characteristic of inattention. B. CORRECT: Frequently interrupting is a characteristic of impulsivity. C. INCORRECT: Being easily distracted is a characteristic of inattention. D. INCORRECT: Talking excessively is a characteristic of hyperactivity.
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While the nurse is collecting data from the client, the history reveals the information provided below. Which of the following should be considered as a possible contraindication for HRT with this client? (Select all that apply.) 1. Type 2 diabetes mellitus 2. Family history of osteoporosis 3. Smokes one pack per day 4. History of blood clot 5. Family history of breast cancer
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3. Smokes one pack per day 4. History of blood clot 5. Family history of breast cancer Smoking can increase the risk for thrombus and should be discouraged prior to beginning therapy. Since venous thrombi can develop as a side effect of HRT, clients who have experienced a blood clot before should not be placed on HRT therapy. Clients who have a family history of breast cancer should consider other options until research can determine if there is a relationship between HRT and increased risk for breast cancer. Type 2 diabetes and a family history of osteoporosis are not contraindications for HRT.
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A client who does not wish to begin HRT but would like to try something for her hot flashes may be counseled to try which of the following? A. Ginkgo biloba B. Black cohosh C. St. John's wort D. Kava kava
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B. Black cohosh Black cohosh has been found to be effective in relieving hot flashes in some women. Ginkgo biloba, St. John's wort and kava kava have not been found to be effective in relieving hot flashes in women who are menopausal.
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Contraindications to estrogen therapy may include which of the following? (Select all that apply.) 1. Estrogen-dependent cancer 2. Post-menopausal osteoporosis 3. Prostate cancer 4. Endometriosis 5. Thromboembolitic disease
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1. Estrogen-dependent cancer 5. Thromboembolitic disease Estrogens are used for contraception, relief of postmenopausal symptoms such as hot flashes, prevention of postmenopausal osteoporosis, treatment of dysfunctional uterine bleeding and endometriosis, and treatment of prostate cancer. They are contraindicated in clients with a history of heart disease, breast- or estrogen-dependent cancer; clients with undiagnosed abnormal vaginal bleeding; or clients with a history of or risk for thromboembolic disease.
