ADHD & conduct disorders Flashcards

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1
Q

ADHD

A
  • persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development
    1. combined type (6 of inattention + 6 of hyperactivity)
    2. inattentiveness (at least 6 of inattention)
    3. hyperactivity/impulsivity (at least 6 of it)
  • *must have symptoms for at least 6 months and in more than one environment
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2
Q

s/s of inattention

A
  • failure to give close or sustain attention to tasks
  • does not seem to listen when spoken to directly
  • does not follow through instructions and fails to finish school work, chores, or duties
  • difficulty organizing tasks and activities
  • often avoids/dislikes engaging in tasks that require sustained mental effort
  • often loses things necessary for tasks or activities
  • easily distracted by extraneous stimuli
  • often forgetful in daily activities
  • **no d/t lack of comprehension or defiance
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3
Q

s/s of hyperactivity & impulsivity

A
  • fidgets with hands or feet, or squirms in seat
  • leaves seat when remaining seated is expected
  • runs or climbs when inappropriate
  • unable to play or engage in leisure activities quietly
  • talks excessively
  • often “on the go”
  • blurts out answer before question is completed
  • difficulty waiting turn
  • interrupts or intrudes on others
  • **inability to delay gratification
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4
Q

environmental factors in ADHD

A
  • lead poisoning

- diet: sugar has not been proven to cause adhd

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5
Q

psychosocial influence in ADHD

A
  • disorganized or chaotic environments
  • disruption in family equilibrium
  • family hx of alcoholism
  • hysterical and sociopathic behaviors
  • parental hx of hyperactivity
  • developmental learning disorders
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6
Q

psychopharmacological interventions

A
  • CNS stimulants
  • selective norepinephrine reuptake inhibitor
  • antidepressant
  • tricyclic antidepressants
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7
Q

CNS stimulants

A
  • increase attention spam
  • improved learning
  • control of hyperactive behavior
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8
Q

CNS stimulant s/e

A
  • anorexia, wt loss, abd pain
  • insomnia, HA
  • increased BP, palpitations
  • decreased growth & development
  • tourette’s tics
  • administer after they eat
  • ritalin
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9
Q

selective norepinephrine reuptake inhibitor s/e

A
  • HA, n/v, dry mouth, decreased appetite
  • upper abd pain, constipation
  • insomnia, increased BP, HR
  • sexual dysfunction
  • get baseline VS before administering
  • Atomoxatine/Stattera
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10
Q

antidepressants

A
  • bupropion (wellbutrin)
  • desipramine (norpramin)
  • contraindications: seizures, heart problems
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11
Q

antidepressant s/e

A
  • insomnia, increased HR, BP, shakiness
  • n/v, wt loss or gain
  • dizziness, HA, dry mouth
  • seizures
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12
Q

tricyclic antidepressants

A
  • nortriptyline (pamelor)

- imipramine (tofranil)

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13
Q

predisposing factors of conduct disorder

A
  • chromosome 2, 19
  • temperament
  • biochemical factors: testosterone, norepi, serotonin
  • impaired social cognition, rejection from peers
  • parents rejection, divorce, absent father,
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14
Q

therapeutic approaches of ADHD

A
  • assess mental status for changes in mood, level of activity, degree of stimulation, and agressiveness
  • ensure client is protected from injury
  • keep stimuli low and environment as quiet as possible
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15
Q

adolescent onset - conduct disorder

A
  • after 10 yrs old

- less likely to display aggressive behaviors, persistent conduct disorder and antisocial personality disorder

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16
Q

child onset - conduct disorder

A
  • prior to 10 yrs older
  • childhood: oppositional defiant disorder
  • puberty: full criteria for conduct disorder
  • adulthood: antisocial personality disorder
  • usually boys
  • frequently display physical aggression
  • disturbed peer relationships
17
Q

adolescent onset - conduct disorder

A
  • after 10 yrs old

- less likely to display aggressive behaviors, persistent conduct disorder and antisocial personality disorder

18
Q

implementation in conduct disorder

A
  • develop a trusting relationship
  • convey acceptance
  • provide immediate, non threatening feedback for unacceptable behavior
  • set limits on manipulative behavior
19
Q

norepinephrine in ADHD

A
  • analysis
  • reasoning
  • cognitive alertness
20
Q

evaluation in conduct disorder

A
  • have the nursing actions toward managing the aggressive behavior been effective?
  • can the client express anger in an appropriate manner?
  • can the client accept responsibility for his own behavior?
21
Q

biological factors influencing ADHD

A
  • genetics (chromosome 16 abnormality)
  • biochemical theory (decreased dopamine and norepinephrine)
  • anatomical influences
  • prenatal, perinatal, & postnatal factors (prolonged labor, prematurity, trauma)
22
Q

dopamine in ADHD

A
  • sensory filtering
  • memory
  • concentration
  • controlling emotions
  • locomotor activity
  • reasoning