NSG 325 - AUTISM SPECTRUM D/O (ASD). STUDY GUIDE.

NSG 325 - AUTISM SPECTRUM D/O (ASD). STUDY GUIDE. AUTISM SPECTRUM D/O (ASD)  A disorder characterized by impairment in social interaction skills and interpersonal communication and a restricted repertoire of activities & interests  Broad spectrum of D/Os including: autistic, Rett’s, childhood disintegrative, pervasive developmental D/O not otherwise specified, & Asperger’s D/O  Presents in early childhood and is more common in boys than girls Manifestations include: a. Sensory integration dysfunction b. Little to no interest in people & often don’t respond to others’ attempts at interaction c. As infants- aversion to affection/physical contact d. As toddlers- attachment to significant adult may be absent or exaggerated e. As children- failure to develop cooperative play, imaginative play, or friendships f. Non verbal communication absent or socially inappropriate g. Language may be absent or impaired h. Routine may become an obsession i. Stereotypical body movements: hand clapping, rocking, whole-body swaying j. Self-injurious behavior: head banging, biting k. Sleep disorders l. Digestive disorders, feeding disorders, &/or allergies m. Epilepsy n. Withdrawal of the child into the self & into fantasy world of his/her own creations o. Wide variability in functioning abilities: i. Poor (inability to perform self-care, inability to communicate and relate to others) ii. High (ability to function at near normal levels) Nursing interventions Initiate a referral for early intervention Provide a structured environment Consult with parents to provide consistent and individualized care Encourage parents to participate in the child’s care and treatment plan as much as possible Use short, concise, and developmentally appropriate communication Identify desired behaviors and reward them Role model social skills Role play situations that involve conflict and conflict resolution strategies Encourage verbal communication Limit self-stimulating and ritualistic behaviors by providing alternative play activities Determine emotional and situational triggers Give plenty of notice before changing routines Carefully monitor the child’s behavior to ensure safety NANDAs  Risk for self or other directed violence  Impaired Social Interaction MEDS: Treat the symptoms  risperidone (Risperdal) or aripiprazole (Abilify): For irritability  olanzapine (Zyprexa): For aggression  fluoxetine (Prozac) or sertraline (Zoloft): For depression & anxiety. Also can reduce repetitive behaviors.