The Child with an Emotional or Behavioral Condition

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Questions and Answers

What is a common behavioral symptom in children suffering from depression?

Elation and energy

Persistent happiness

Aggression and withdrawal (correct)

Increased sociability

Why is it important to recognize differences in behavioral conditions between children and adults?

Children and adolescents may present symptoms differently (correct)

Behavioral conditions are less severe in children

There are no differences between adult and child behavior

Children are simply small adults

What developmental impact can early life events have on behavioral conditions?

They are irrelevant to future conditions

They may influence future problems (correct)

They cause permanent conditions

They only affect later adolescent behavior

What is a potential outcome of effective intervention in children's emotional problems?

Complete recovery from the problems (A) Signup and view all the answers

In what context might children with depression exhibit somatic symptoms?

In varying forms depending on age (A) Signup and view all the answers

How many academic hours are allocated for the lesson on emotional and behavioral conditions in pediatric nursing?

4 hours (C) Signup and view all the answers

What overarching theme is taught in this lesson regarding children and adolescents?

Differences exist compared to adults in care approaches (D) Signup and view all the answers

What is not a requirement for students taking this lesson?

Completion of a prerequisite lesson (A) Signup and view all the answers

What is the primary focus of therapies for infants and toddlers with emotional or behavioral issues?

Parent-child relationships and behavior modification (A) Signup and view all the answers

Which type of therapy involves modifying behaviors by means of stimulus and response conditioning?

Behavior modification (D) Signup and view all the answers

What is a significant characteristic of dysfunctional families?

Indifference to children's emotional needs (A) Signup and view all the answers

Which diagnostic manual is used to aid in the diagnosis of mental health conditions in children?

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (C) Signup and view all the answers

What is the main goal of all forms of therapy provided to children with behavioral conditions?

To promote optimal functioning of the family (A) Signup and view all the answers

What is dyslexia primarily associated with?

Difficulty with reading (C) Signup and view all the answers

Which statement reflects a behavior often associated with nervous tension and anxiety stemming from a dysfunctional family?

Nail biting or excessive fears (A) Signup and view all the answers

Which of the following is NOT a suspected cause of dyslexia?

Environmental toxins (A) Signup and view all the answers

What is implied by the term 'knowledge inferred from cognitive learning activities' in the evaluation context?

Applying learned concepts in practical settings (C) Signup and view all the answers

Which tool is primarily used to evaluate the performance of skills in a lab setting?

Performance checklist (D) Signup and view all the answers

Early signs of dyslexia can include which of the following?

Difficulty learning nursery rhymes (A) Signup and view all the answers

Which of the following management strategies is NOT recommended for autism spectrum disorders (ASD)?

Providing poorly structured environments (D) Signup and view all the answers

What is a common misunderstanding about the role of behavior modification therapy?

It involves modifying specific behaviors through conditioning (D) Signup and view all the answers

What is the impact of early childhood experiences on personality development?

They can disrupt family patterns and affect self-perception (B) Signup and view all the answers

What defines obsessive-compulsive disorder (OCD)?

Recurrent thoughts and ritualistic behaviors (A) Signup and view all the answers

Attention deficit/hyperactivity disorder (ADHD) often includes which of the following characteristics?

Developmentally inappropriate hyperactivity (B) Signup and view all the answers

Which of the following is NOT typically a condition resulting from a dysfunctional family?

High trust in caregivers (B) Signup and view all the answers

In what environment is skills learning primarily practiced and evaluated?

Skills Lab environment (D) Signup and view all the answers

Which of the following is an appropriate medication for managing ADHD?

Stimulant medications (A) Signup and view all the answers

Which condition can commonly co-occur with ADHD?

Dysgraphia (B) Signup and view all the answers

Which of the following statements about assessments is FALSE?

Clinical evaluations only occur after written tests. (C) Signup and view all the answers

What is a common early sign of autism spectrum disorders (ASD)?

Difficulty with social interactions (D) Signup and view all the answers

What is NOT a characteristic of obsessive-compulsive disorder?

Social withdrawal (B) Signup and view all the answers

What type of environment is recommended for children with ADHD?

Quiet and distraction-free environments (D) Signup and view all the answers

How does dysgraphia primarily manifest in children?

Problems with spelling and writing (C) Signup and view all the answers

What is a key goal of therapy for children diagnosed with ASD?

To maximize independence (C) Signup and view all the answers

What is a misconception about ADHD?

ADHD only affects children (D) Signup and view all the answers

What specific information should the nurse gather from Christopher's mother during the admission process?

How Christopher copes with changes in his schedule (B) Signup and view all the answers

Which strategy is effective when interacting with Christopher, who has anxiety about his surgery?

Ask permission before making physical contact (A) Signup and view all the answers

Why may other children in Christopher's family feel resentment toward him?

Their parents spend too much time with Christopher (B) Signup and view all the answers

During the summary, which point is NOT a focus of the main discussion?

The effectiveness of medication for autism (D) Signup and view all the answers

What is one method instructors used to evaluate student understanding?

Written and oral assessments (A) Signup and view all the answers

Which factor is important to consider when interacting with Christopher in a surgery unit?

His potential anxiety about healthcare personnel (C) Signup and view all the answers

What should the nurse do if Christopher is anxious about the medical equipment?

Allow him to handle and demonstrate the equipment (A) Signup and view all the answers

What may young siblings of children with autism struggle to understand?

Why their sibling interacts differently and avoids play (C) Signup and view all the answers

Which substance is commonly associated with the street name 'smack'?

Heroin (D) Signup and view all the answers

What is a common effect of bath salts when abused?

Euphoria (B) Signup and view all the answers

Which of the following statements about alcoholism is accurate?

Alcoholism often affects family dynamics. (C) Signup and view all the answers

What is a first step in preventing substance abuse among children?

Developing a positive self-image (A) Signup and view all the answers

What is the student to instructor ratio for the Registered Nurse (RN) Instructor Supervisor?

1:55 (B) Signup and view all the answers

Which coping pattern is characterized by a child trying to be the perfect child for parental approval?

Perfect child (D) Signup and view all the answers

Which equipment is required for instruction in the training program?

Digital Still Camera (A) Signup and view all the answers

What is a typical characteristic of children of alcoholics?

Feelings of responsibility for family issues (B) Signup and view all the answers

What is one of the essential skills nurses must develop when working with children and adolescents?

Engaging clients and establishing rapport (A) Signup and view all the answers

How do strict family environments commonly affect adolescents?

They can contribute to feelings of powerlessness. (D) Signup and view all the answers

What is the total man hours required for the Registered Nurse (RN) Instructor Supervisor?

5 hours (C) Signup and view all the answers

Which program is specifically designed to support young people affected by another's drinking?

Al-Anon/Alateen (D) Signup and view all the answers

What classroom environment is specified for the training?

CLASSROOM (68C, PH2) (D) Signup and view all the answers

Which of the following is NOT a student material required for the lesson?

Clinical Psychology Textbook (C) Signup and view all the answers

Which of the following is a risk of siblings of children with emotional disorders?

Difficulty developing peer relationships (B) Signup and view all the answers

What type of instruction method is utilized in this training program?

Lecture (C) Signup and view all the answers

What is an immediate priority in caring for children of alcoholics?

Teaching emergency help procedures (C) Signup and view all the answers

What is a long-term impact on siblings of children with emotional disorders?

Development of low self-esteem (D) Signup and view all the answers

What is the Risk Assessment Level mentioned for the training environment?

Low - 1 (A) Signup and view all the answers

How many hours is the time of instruction set for?

5 mins (A) Signup and view all the answers

Which substance is often referred to as a 'gateway substance'?

Alcohol (A) Signup and view all the answers

What strategy is NOT recommended for preventing substance abuse in children?

Isolation from peers (C) Signup and view all the answers

Which of the following is a duty required of the RN Instructor Supervisor?

Supervise the class (D) Signup and view all the answers

What is an effect of emotional neglect in children of alcoholic parents?

Emotional scars or complications (A) Signup and view all the answers

What is the importance of early intervention with children and adolescents?

It is often more effective than later management. (D) Signup and view all the answers

What environmental consideration must instructors keep in mind during training?

Risk assessment according to environmental guidelines (C) Signup and view all the answers

What is the primary focus of the nursing care to be performed upon completing the lesson?

Nursing care for a child (B) Signup and view all the answers

What special instructions for the instructor are mentioned?

No special instructions are provided. (C) Signup and view all the answers

Which of the following characteristics is typically associated with ADHD?

Hyperactivity (D) Signup and view all the answers

What indicates that a child might struggle with a learning disability?

Need for specialized instruction (D) Signup and view all the answers

What is a common physical symptom observed in adolescents with anorexia nervosa?

Severe weight loss (D) Signup and view all the answers

Which of the following is NOT a characteristic of bulimia?

Extreme weight loss (C) Signup and view all the answers

What would be the most appropriate response to a parent concerned about their child's ADHD potentially improving with age?

These behaviors might continue into adulthood. (D) Signup and view all the answers

Which factor is commonly found in adolescents who develop eating disorders?

Affluent, dysfunctional families (C) Signup and view all the answers

What is a critical nursing consideration when working with adolescents displaying signs of eating disorders?

Establishing trust with the adolescent (B) Signup and view all the answers

Which treatment approach might be utilized for adolescents struggling with anorexia nervosa?

Individual and family psychotherapy (D) Signup and view all the answers

Which statement about depression in childhood is accurate?

Children may express depression through behavioral issues. (C) Signup and view all the answers

What could be a long-term complication of untreated anorexia nervosa?

Gastritis or kidney problems (A) Signup and view all the answers

Which behavior is commonly a contributing factor to bulimia?

Binge eating followed by compensatory behaviors (A) Signup and view all the answers

Which psychological factors are often seen in individuals with anorexia nervosa?

Perfectionism and low self-esteem (A) Signup and view all the answers

In managing children with learning disabilities, what is a key role of school nurses?

Collaborating with parents and teachers (D) Signup and view all the answers

What is a common method for treating children with ADHD?

Education on medication adherence (C) Signup and view all the answers

What is a characteristic behavior of children with depression?

Withdrawal from previously enjoyed activities (C) Signup and view all the answers

What is a significant risk factor for suicidal behavior among children?

Parental indifference or low expectations (D) Signup and view all the answers

Which of the following symptoms must be present for at least one year to establish a diagnosis of major depressive disorder in children?

Diminished affective responses (C) Signup and view all the answers

What nursing consideration is essential for managing depressed children?

Education for the child and parents on the plan of care (D) Signup and view all the answers

Which one of the following behaviors is categorized as a suicidal ideation?

Having recurring thoughts about death (D) Signup and view all the answers

What differentiates abuse from dependence in substance use?

The compulsive need to use a substance (C) Signup and view all the answers

Which characteristics can indicate a child may be at high risk for suicide?

Giving away prized possessions (C) Signup and view all the answers

What is a common symptom seen when children experience changes in appetite due to depression?

Weight loss or weight gain (C) Signup and view all the answers

What is the primary focus of cognitive behavioral therapy in treating depression?

Emotional management skills and problem-solving (A) Signup and view all the answers

What is a behavioral sign of a depressed child in school?

Cutting classes or dropping out of activities (A) Signup and view all the answers

Which of the following is a primary nursing consideration for children at risk for self-harm?

Educating families about available community resources (C) Signup and view all the answers

What is the mental state associated with depression as per reported signs?

A sense of hopelessness or guilt (C) Signup and view all the answers

What signifies a potential acute risk of suicidality in children?

Distant behavior and flat affect (A) Signup and view all the answers

Study Notes

Child Needing Nursing Care III: Emotional/Behavioral Conditions

Scope: This lesson covers providing safe, effective care for children and families facing emotional/behavioral issues. Key point: Childhood disorders differ from adult disorders in presentation and require specific treatment approaches.
Administrative Data:
- Course: Practical Nurse (300-68C10), Version 2.0, 2023
- No prerequisites: No prior knowledge or lessons required.
- Academic Hours: 4 hours for resident; 2 hours for formal testing (test review included).
- Clearance: No security clearance or access requirements. Releaseable to students globally.
- References: Introduction to Maternity and Pediatric Nursing, 8th Ed. (2019).
- Student Assignments: Read Chapter 33 of the textbook; complete handouts and VCLASS quizzes.
- Instructor Requirements: Align with Texas Board of Nursing qualifications; records maintained by Program Director.
- Support Personnel: Registered Nurse (RN) Instructor Supervisor (Officer) ratio 1:55; 1 supervisor needed; 5 hours of support.
- Equipment: Classroom, projector, monitor, pen display, camera, instructor laptop.
Introduction:
- Instruction Method: Lecture
- Instructor-to-Student Ratio: 1:55
- Instruction Time: 5 mins
- Media: Lecture.
- Motivator: Working with children is challenging yet rewarding; early intervention makes a large difference in their lives. Successful interventions create stronger emotional, psychological, and physical growth.
- Lead-In: Nurses need to establish rapport, observe behaviors in the psychosocial context, and collect comprehensive assessments. Establishing trust is vital for successful collaboration.
Terminal Learning Objective: Upon completion, students will perform safe, effective nursing care for children with emotional/behavioral disorders without causing harm.
Safety: Risk assessment (DD Form 2977) is mandatory; focus on low-risk activities like trips, falls, and ergonomic hazards.
Environmental Considerations: Risk assessment and environmental hazard awareness required; compliance with environmental protection regulations and guidelines.
Evaluation Method: Three arenas for evaluation: cognitive (written exams), skills (skills lab), and clinical (patient care).

Enabling Learning Objective

Action: Perform nursing care for a child
Conditions: In a clinical environment, given a scenario of a child experiencing different emotional or behavioral conditions
Standards: Provide safe and effective care for a child facing emotional/behavioral conditions.

Learning Step / Activity 1: Role of Nurses and Treatment Settings

Instruction Method: Large group discussion; time: 15 mins
Nurse Role: Nurses are often the primary point of contact for families. Assessing parent-child relationships is critical. Understanding typical behaviors in children of different ages is essential for intervention.
- Diagnostic Resources: DSM-5 (Mental Disorders), RDC-PA, Zero to Three Diagnostic Classifications for infants and children.
- Intellectual Disability: Impaired general mental function impacts daily tasks (language, reading, communication, etc.).
- Infants/Toddlers: Focus on parent-child relations and behavior modification.
Treatment Settings/Types:
- Settings: Child guidance clinics—multi-disciplinary teams.
- Types: Direct/indirect interventions, individual, family, or group therapy, behavior modification, milieu therapy, family-focused approaches, emotionally safe environments
- Causes: Dysfunctional families (conflict, chaos, lack of structure, indifference) may lead to impaired trust, fear, anger, feeling out of control or negative feelings about self..

Learning Step / Activity 2: Organic Behavioral Disorders in Children

Instruction Method: Large group discussion; time: 35 mins
Learning objectives:
- Learning Disabilities: Impact information acquisition, retention, understanding, and organization. (Dysgraphia, dyslexia, dyscalculia)
- Suspected Causes: Perinatal issues (low birth weight, prenatal exposure, genetics, abuse)
Autism Spectrum Disorder (ASD): Neurodevelopmental disorder marked by social/communication challenges, repetitive behaviors, and specific interests. Diagnosis may occur between 1–2 years to 18 years old.
Obsessive-Compulsive Disorder (OCD): Repetitive thoughts (obsessions) and ritualistic behaviors (compulsions); impact on cognitive or social functioning is not apparent.
Attention-Deficit/Hyperactivity Disorder (ADHD): Developmentally inappropriate inattention, impulsivity, and hyperactivity. Possible causes include prenatal diet and genetics.
- Symptoms: Inattention, impulsivity, hyperactivity
- Management: Family education, medication (common stimulants: Ritalin, Concerta), classroom accommodations, behavioral therapy, environmental manipulation.
- Nursing Considerations: Classroom strategies, medication management, instruction to schools and families, tutoring, and computer assistance.
Eating disorders: (Anorexia, Bulimia); risks related to body image.
Nursing considerations: Prevention of eating disorders, and establishing trust in the adolescent. Recognizing early warning signs such as body image issues, amenorrhea, social isolation.
Long-term consequences: untreated eating disorders can cause gastritis, cardiac dysrhythmias, intestinal inflammation, kidney issues, and even death from electrolyte imbalances.

Learning Step / Activity 3: Environmental/Biochemical Disorders in Children

Instruction Method: Large group discussion; time: 35 mins
Mood Disorders (e.g., Depression): Difficulty expressing feelings, acting out, varied symptoms in children. Chronic versus temporary depression
- Symptoms: Sadness, lack of interest in activities, changes in appetite and sleep patterns, and possible suicidal thoughts.
Suicide: Third leading cause of death in adolescents. Suicidal ideation, gestures, attempts. Risk factors: loss, family disruption, history of mental health problems, abuse.
- Risk Factors: Parental loss, family disruption, family history, abuse (physical and emotional).
Substance Abuse: Alcoholism (gateway substance), substance abuse, drug tolerance, dependence, risk factors for developing problems.
- Alcoholism: A preventable and treatable disease; various resources are available for support and recovery(Al-Anon and Alcoholics Anonymous).
Impact on Growth and Development: Stress, coping skills, family support.
Effect on Siblings: Rivalry, guilt, protective coping, long-term peer relationship challenges.

Case Study: Discussion

Patient Situation: Nine-year-old Christopher with autism facing a hospital experience.

Summary/Review

Instruction Method: Lecture; time: 10 mins
Review: Recap key points discussed.

Student Evaluation

Testing Requirements: Individual Student Assessment Plan provides specific details for testing via written exams, oral exams, simulations, and/or clinical performance assessments.
Feedback: Timely feedback on evaluations for remedial training and questions.

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Description

This quiz covers critical aspects of emotional and behavioral conditions in pediatric nursing. It emphasizes the importance of recognizing depression symptoms in children, understanding developmental impacts of early life events, and the significance of effective interventions. The lesson aims to equip students with essential knowledge for addressing children's emotional problems.