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20 Cards in this Set

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ADHD
DEFINE
a neuro biological disability with the essential freature is a persistent pattern of inattention and/or hyperactivity than is more common than gernerally observed in children of the same age
ADHD
When is it often diagnosed
when the child starts preschool or school althogh it may be evident starting in infancy. can present into adulthood. early detect essential
ADHD
who must evaluate the child
a qualified specialist to avoid over diagnosis
ADHD
criteria for diagnose
NO physical test
must meet the DSM IV TR criteria
requires evidence obtained from parents regarding core symptoms
rq's evidence obtained from teacher/other school prof regarding core symptoms
ADHD
what do you evaluate with the parent
the history
interview with both child and parent to r/o psychiatric/environmetnal causes
ADHD
evaluation school
documetns specific elements of inattention, hyperactivity and impulsivity and impact on school function. uses standard rating scales/narratives/school work/previous testing
ADHD
evaluation of the child
a physical
a neurological exam
a neurodevelopmental eval
mental status exam
DSM IV TR CRITERIA SUB-TYPE 1
Inattentive type/ requirement
6+ out of 9 symotoms that have lasted for at least 6mo to a degree that is maladaptive and inconsistent with developmental level of the child
DSM IV TR CRITERIA SUB-TYPE 1
Inattentive type/ symptoms
1 often misses details, makes careless mistake
2. often has difficulty sustaining attention
3. often dosen't seem to listen
4. often does not follow through on chores or homework
5.often has difficulty w/org
6.often avoids tasks requireing mental effort
7. often loses necessary things
8. often easily distracted by other stimuli
9. Often forgetful in daily activites
DSM IV TR CRITERIA SUB-TYPE 2
Impulsivity type/ requirement
6 or more symptoms that have persisted for at least 6mo to a degree that is maladaptive and inconsistent with developmental level
DSM IV TR CRITERIA SUB-TYPE 2
Impulsivity/hyperactiviy
symptoms
1. often figits and squirms
2. often leaves seat
3. often runs or climbs excessively
4. often can't play quietly
5. often always on the go;driven
6. often talks excessively
7. often blurts out answers before question completed
8. often has difficulty waiting a turn
9. often interrupts others (butts into conversations or games)
DSM IV CRITERIA FOR BOTH SUB-TYPES
symptoms that caused impairment have been present before age 7
some impairement from the symptoms is present in 2 or more setting
clear evidence of clinically significatn impairment in social, academic or work functioning
ADHD Etiology
no definitve cause;
biological, genetic, biochemical theory, prenatal, perinatal, environmental factors, psychosocial factors
cause is MULTIFACTORAL
ADHD
MED MANAGEMENT
stimulant drugs are used ie
ritalin
concera
dexedrine/dexedrine sr
cylert
COMMON SIDE EFFECTS OF ADHD MEDS
insomnia
loss of appetiti
weight loss or failure to gain weight
cylert can cause liver damage, last resort
MEDICATION AND BEHAVIORAL STRATEGIES
both meds and behavioral strategies are needed. behavioral strategies are needed components in home and school ex; provide rewards and consequences of behavior, giving consistent praise, using timeout, verbal reprmands, point system for + and - behavior
Nursing process
Assessment
gathers info from parents, child, teachers as well as direct observation
history
general appearence and motor behavior
mood and affect/may be labile
intellectual/attention
judgement/insight
self concept
roles and relationships
physiologic / self care
Nursing DX
risk for injury
ineffective role performance
impaired social interaction
compromised family coping
nursing process/ interventions
ensuring safety always a TOP priority
simplifying instructions
promoting structure
promoting family education and support
LOTS OF REINFORCEMENT
NURSING PROCESS/ EVALUATION
SUCCESSFULLY completes tasks
demonstates acceptable social skills
participation in educational settings
ability to complete taks w/reminders
successful interactions with family and peers, verbalize positive statements of self
complete tasks individually