PALS Tutoring QUIZ 5 - week 5 marrast PDF

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week 5 marrast...

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PALS TUTORING QUIZ 5 

Stereotypic Movement Disorder o Starts at age 3 o More severe and intense than Tourette’s o Lasts longer than Tourette’s o Repetitive bilateral movements  Hand waving  Head banging  Nail biting  Teeth grinding o Interventions:  Safety- helmets, fold/cross their arms  Naltrexone

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Tourette’s Disorder o Starts at 6-7 o Persistent motor or tick’s disorder o Unilateral movements  Head limbs  Hopping  Squatting  Verbal ticks  Tongue protrusion o Coprolalia  Uttering, swearing

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Autism Spectrum Disorder o Spectrum: mild to severe o Appears during the first 3 years of life o Inappropriate responses in conversation o Difficulty building friendships o Dependent on routines o Sensitive to changes in the environment o Intensely focused on inappropriate items o Treatments:  Behavioral management  Reward systems  Speech therapy  Physical therapy

Attention Deficit Hyperactivity Disorder (ADHD) o Hyperactive  Fidgeting  Running  Climbing o Impulsive o Inpatient o Do not focus well o Diagnosis:  Have several symptoms that is in more than one setting o Interventions:  Have pt release energy in a safe way  Ex) Walking, basketball  Reward System 

Medications  Psycho stimulants  Benefits must outweigh risks: o Some risks  Increased BP and HR  Insomnia  Weight loss  Increase focus and attention, decreases restlessness  No phone orders  Could develop a substance abuse disorders 

Short Acting Methylphenidates o Last for 3-4 hours  Methylphenidate (Ritalin)  Focalin D-Isomer of Ritalin  Methylin CT (chewable)  Methylin Oral Solution (clear grape flavored liquid)

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Intermediate Acting Methylphenidates o Last for 4-8 hours  Ritalin SR  Metadate ER (Generic)  Methyline ER o Take in the morning o CANNOT CRUSH OR CHEW

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Long-Acting Methylphenidates o Last for 8-12 hours  Concerta  Metadate CD  Focalin XR  Ritalin LA  Daytrana  Place the patch on hip daily and leave in place no longer that 9 hrs  Rotate spots for less irritation  Flush down the toilet = DO NOT THROW AWAY, someone can find it and put it on themselves Amphetamines o Short Acting (3 – 5 hours)  Dextroamphetamine sulfate (Dexedrine)  Dextrostat  Desoxyn o Intermediate acting (4 – 8 hours)  Adderall o Long Acting (8 – 12 hours)  Dexedrine Spansules  Adderall XR  Vyvanse o S/E:  Wt loss  Decrease appetite  Insomnia  Increase BP and HR  Stunts growth o Take in the morning and at or after breakfast- high calorie, nutritious meal

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Acute Stress Disorder o Occurs within 3 days of event and last 1 month  Ex) car accident, rape, loss of loved one o Same symptoms as PTSD o To be diagnosed with ASD:  8 of the following 14 symptoms during or after the traumatic event:  Subj. sense of numbing  Derealization

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Inability to recall one important event Intrusive/distressing memories Recurrent distressing dreams Feeling that event is recurring- ruminating Intense prolonged distress Avoidance of thoughts or feelings Sleep disturbances Hyper vigilance Irritability Anger or aggressive behavior Exaggerated startle response Agitation or Restlessness

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PTSD o Occurs longer than 1 month  How long after the event has occurred  Re-experiencing of the trauma  Avoidance of stimuli associated with trauma  Persistent symptoms of increased arousal  Alterations in mood  Moral Injury (not included in the DSM5)  Do not talk about traumatic event  Obsess about the event (think about it)  They would not want to go back at the scene of the event  Negative self-image  Reoccurring nightmares  Hyperactive reflexes/ on edge/ hypervigilance  Avoiding memories or places  Experiences flashbacks  Irritability and anger  NOT driven to repeat selective behaviors= ONLY THOSE WITH OCD  Distressful  Feel empty inside  Ex) military combat, auto accident, assault, life threatening illness o Interventions:  Slowly allow the pt to open up and talk about their feelings (baby steps)  Guided imagery

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QUESTION:

o Which of the following prescribed to a PTSD pt will help decrease nightmares and sleep disturbances SATA: a) Sertraline (Zoloft) b) Mirtazapine (Remeron) c) Prazosin (Minipress) d) Paroxetine (Paxil) e) Topiramate (Topimax) 

Adjustment Disorder: o Milder form of ASD o Less severe event o Symptoms:  Loss of sense of self, difficulty concentration, empty feeling, guilt, anger (SIMILAR TO ASD AND PTSD)  Ex) breakup, divorce, chronic disease, retirement

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Dissociative Disorders o Depersonalization  Loss of sense of self o Derealization  Change in environment o Dissociative Amnesia  Inability to recall important personal information usually from traumatic event o Dissociate Identity Disorder (DID)/ Multiple Personality Disorder (MPD)  Presence of 2 or more distinct personalities  Alters know about each other and about the host  Each alternate personality (alter) has own pattern of  Perceiving  Relating to and  Thinking about the self and environment  Ex) Fight Club, Me myself and Irene, Split 

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Interventions:  1:1 monitoring

Conversion Disorder o Neurological symptoms in the absence of a neurological diagnosis o Presence of deficits in voluntary motor or sensory functions o Common symptoms  Paralysis

 Blindness  movement and gait disorders  numbness, paresthesia  loss of vision or hearing, or episodes resembling epilepsy o La Belle Indifference:  Lack of concern or anxiety  Lack of emotion  They know subconsciously that something is wrong o Interventions ¡ Ex) Girl gets physically assaulted and 3 days later cannot walk. 

Illness Anxiety Disorder (hypochondriac) o Blow symptoms out of proportion o Seek more medical care or avoid medical care o Misinterpretation of physical symptoms as evidence of illness  Ex) “My stomach is cramping and they ran tests that were negative, but I’m sure it is cancer.”

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Somatic Symptom Disorder o Higher incidence in women o Real symptoms and response with no medical findings o Its real to them  Ex) Patient has pain and lethargy and complains about it often, but no medical reason can be established

Factitious Disorders  Malingering o Making up symptoms for personal gain  Ex) faking symptoms to avoid something else  Ex) stay in the hospital longer 

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Munchausen Syndrome o Artificially, deliberately, and dramatically fabricate symptoms or self-inflict injury o Goal of assuming a SICK ROLE o Person makes themselves sick Munchausen by Proxy o The act of making someone else sick o Need for attention

UAP

o CANNOT DO (TAPE)  Teach  Assess  Plan  Evaluate...