ADHD Flashcards

1
Q

What is adhd?

A
  • developmentally inappropriate degree of inattention, hyperactivity and impulsivity
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2
Q

what the dsm-5 diagnosis?

A

persistent pattern of innatention and/or hyperactivity-impulsivity that is more freq displayed and more severe than is observed in individuals at a comparable lvl of development

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3
Q

what are signs of inattention?

A
  • doesnt pay attention
  • daydreaming
  • easily distracted from work or play
  • doesnt follow through w instructions
  • disorganized
  • avoidance of doing task that req mental focus
  • forgetful of daily activities
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4
Q

what are signs of hyperactivity?

A
  • in constant motion
  • cant stay still
  • fidgets
  • runs, jumps, climbs when not permitted
  • diff w engaging in leisure activity quietly
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5
Q

what are signs of impulsivity?

A
  • freq acts or speaks without thinking
  • running into traffic without looking
  • impatient
  • calls out answer without raising hand
  • interrupts others
  • difficulty waiting for turn
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6
Q

How is ADHD displayed in adults?

A
  • trouble concentrating
  • restlessness
  • diff completing task
  • disorganized
  • impulsive
  • low frustration tolerance
  • freq mood swings
  • hot temp
  • trouble coping w stress
  • unstable relationship
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7
Q

what are some myths related to adhd?

A

these things cause adhd:
- sugar
- food dyes
- watching tv
- poor family life (however, can have negative impact on fx of home)

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8
Q

what is the etiology of adhd?

A

genetics

brain inju

exposure to env toxins

exposure to harmful subs during pregnancy

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9
Q

what conditions mimic adhd? its important to rule these out

A
  • emotional problem/ abuse
  • learning disabilities
  • petit mal (absent) seizure
  • vision and hearing problem
  • brain injury
  • sleep disorder
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10
Q

what is the phenomology of adhd?

A
  • poor school performance
  • trouble w law
  • problems at work
  • alcohol and drug abuse
  • freq car accidents
  • unstable rel
  • financial stress
  • poor physical and mental well being
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11
Q

how do you diagnose adhd? what are the 4 criterias?

A

1) must have at least 6-9 symp for one of the adhd subtypes
2) childhood onset of symp (age 7 or younger)
3) impairment in at least 2 of the following:
- work
- school
- social setting
4) symp cant be episodic (must exist for at least 6mo)

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12
Q

what are the subtypes of adhd?

A
  • innatentive
  • hyperactive
  • impulsive
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13
Q

what are some strategies for parents with kids whi have adhd?

A
  • be consistent, set limits and have clear consequences for childs behavior
  • put together daily routine (bedtime, morningtime, mealtime, simple chores, tv)
  • avoid multitasking when taking to child, make eye contact when giving instructions
  • set aside couple minutes q day to praise child
  • work w teacher
  • simplify childs schedule
  • quite work environemnt
  • encourage engagement in sports and social activities
  • limit amount of time spent on tv and video games
  • set clear expectation and rules
  • encourage healthy eating habits
  • encourage friendships
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14
Q

what pharmacological medications are used for adhd?

A
  • psychostimulants
  • non stimulants (SSRI, selective aplha 2 adrenergic receptor antagonist, TCA)
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15
Q

What are psychostimulants?

A

1st line therapy => improves focus, self-control, working memory and creative thinking

increases dopamine (may produce euphoria -> abuse for recreational use = aggression and paranoia)

must be tapered bcz associated w withdrawal syndrome

2 kinds:
1) methylphenidate (concerta, biphentin, ritalin)
2) amphetamine (vyvanse, adderall)

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16
Q

what are nursing considerations related to concerta?

A

ages 6-65

not for pt w underlying heart cond

extended rel tabs only

17
Q

what are nursing considerations related to biphentin?

A

not available in short acting (action = 10-12 hr)

for kids w diff swallowing pills

18
Q

what are nursing considerations related to ritalin?

A

short and long acting (up to 4h or 8h)

prefer prescribing long acting and adding short prn as “top off”

dont crush

19
Q

what are nursing considerations related to vyvanse?
NOT ON EXAM

A

minimun 6 yo

cant be used w moai

can be used for being eating disorder

action = 10-12 h

20
Q

what are nursing considerations related to adderall?
NOT ON EXAM

A

short acting (4-6h) and extended rel (10-12h)

may cause slow growth in children

21
Q

what are the side effects of psychostimulants? what should you immediately report?

A
  • decreased appetite
    - peaks at lunch time
    - eat nutritious breakfast before taking pill in am
    - provide snack (at lunch + hungry as med wears off)
  • insomnia
    - takes time to readjust (4-6 wks)
    - encourage quiet activity before bed
    - provide bed time routine
    - avoid TV, caffeine, large meals before bed
    - encourage child to keep an open dialogue abt stress
    inducing situations
  • anxiety
  • irritability
  • nausea
    - take w food
    - eventually subsides
  • dizziness
  • increased bp + hr + temp

immediately report:
- heart palpitations
- suicidal thoughts
- changes in mood and personality
- irritability for long periods of time
- tics
- aggressive or paranoid thoughts

22
Q

what are nursing considerations related to the ssri: atomoxetine?
NOT ON EXAM

A

for ppl w underlying anxiety

first line for non stimulants

action = 24h

side effects: nausea, upset stomach, decreased appetite, wt loss, fatigue, mood swings, drowsiness

23
Q

what are nursing considerations related to the selective alpha 2 adrenergic receptor agonist: guanfacine?
NOT ON EXAM

A

dont dc abruptly (can increase bp and hr)

action 24h

avoid grapejuice

side effects: bradycardia, syncope, dry mouth, drowsiness, irritability, wt gain, nausea, irritability upset stomach

24
Q

what are nursing considerations related to TCAs?
NOT ON EXAM

A

used if underlying depression

adjunctive therapy

increases serotonin and norepi

side effects: dry mouth, constipation or urinary ret