ADHD Flashcards
Copy/Past from PP slides
ADHD vs ADD
ADHD: condition where individual has difficulty completing tasks that require focused attention, hyperactivity, hyperkinesis, impulsivity
ADD: individuals who experience the inattentiveness and difficulty concentrating that accompanies ADHD
Pathophysiology of ADHD
Pathophysiology is unclear.
Deficit in dopamine and norepinephrine
Delay in brain maturation in the areas of self-regulation
Etiology:
Several different mechanisms involving genetic, biologic, environmental risk factors
Prenatal factors:
ADHD Risk Factors and Prevention
Risk factors
Interaction of genetic, biological, environmental factors
Prenatal exposures
No single gene located at this timeNo known prevention
Avoid drugs, smoking, and alcohol during pregnancy
Consistent behavioral rules
ADHD Diagnostic Tests
Family history Birth history Growth, developmental milestones Behaviors Sleep, eating patterns Progression, patterns in school Social, environmental conditions
Reports from parents, teachers. Frequently diagnosed after beginning school
Often brought in when behaviors interfere with daily functioning of teachers, parents
Diagnostic criteria:
Inattention
Hyperactivity
Impulsivity
Pharmacologic Treatment
*Need to watch for weight loss
Moderate to severe ADHD QAM dosing
CNS Stimulants (Mechanism of actions poorly understood? Blocks reuptake of dopamine and norepinephrine) *Methylphenidate *Ritalin *Concerta Dextroamphetamines *Dexedrine *Adderall Atomoxetine (SNRI) *Strattera: SNRI, non addictive properties, takes 4 weeks to come in effect
Nonpharmacologic Therapy
Environmental modification *Decreasing stimulation *Orderly environment Behavioral therapy *Reward child for desired behaviors *Apply consequences for undesirable behaviors
ADHD Nursing Diagnosis
Nursing diagnoses may include: Risk for Injury Impaired Verbal Communication Impaired Social Interaction Chronic Low Self-Esteem Risk for Caregiver Role Strain
Planning for ADHD
Prevention
*Discourage regular television, encourage physical activity for young children (cannot filer sounds, wind down stimulation)
Hospitalized child (Routine is important)
*Administer medications
*Manage environment (Enforce sleep/rest/visit time)
*Implement behavioral management plan
*Provide emotional support
*Promote self-esteem
*Ensure ongoing care
Implementation for ADHD (pharm)
Administer pharmacologic treatments
- Teach parents to be alert for common side effects of medications (Insomnia, dose time important)
- Administer medication early in the day to help alleviate insomnia
- Perform careful periodic monitoring of weight, height and blood pressure
- Instruct families about abuse potential of stimulant drugs
Implementation for ADHD (environment)
Minimize environmental distractions
- Keep potentially harmful equipment out of reach
- Limit and monitor screen time
- Provide a quiet, clutter-free area for study time
- Use shades to darken the room during naps or at bedtime and minimize noise
- Teach parents to minimize distractions at home during periods when the child needs to concentrate
When child is hospitalized, may need to place child in room with only one other child
Implementation for ADHD (family)
Provide emotional support
*Family support is essential.
*Follow routines
*Respite care for parents (b/c they’re exhausted)
Educated families
*Explain what the diagnosis is and what is known about the disorder
*Emphasize the importance of a stable environment
*Reinforce the importance of providing s structured environment
*Encourage children to keep assignment notebooks and use checklists
Implementation for ADHD (esteem)
Promote self-esteem
- Assist the child with social skills through the use of role playing, small group play, and modeling
- Emphasize the positive aspects of behavior and treating instances of negative behavior as learning opportunities
- Help child develop ego strengths
- Encourage skills at which the child excels and consider the use of support groups for children in school
- Praise the hospitalized child for lying still for a procedure, taking medication on time, or helping a staff member carry toys around to other children.
Evaluation for ADHD
Expected outcomes may include:
- Parents, child demonstrate understanding
- Family accurately, safely manages medication administration
- Child demonstrates increased attentiveness, decreasing hyperactivity
- Child displays formation of positive self-image
- Child manifests formation of healthy social interactions with peers, family
- Child achieves educational performance to maximum potential
