Marked by
-Inattention
-Hyperactivity
-Impulsivity
ADHD
3 characteristics of ADHD
Inattention, hyperactivity/impulsivity
a nurse is evaluating a 8-year-old female who demonstrates the following behaviors : "daydreaming" poor school performance, constant fidgeting, interrupting others, and mood swings. Her speech development is appropriate for her age. Which disorder would t
ADHD
Epidemiology of ADHD
Boys>girls
Concurrent difficulties with ADHD in childhood
Injuries
Academic underachievement
Relationships
Concurrent difficulties for ADHD in adolescence
Motor vehicle accidents
low self esteem
Smoking/substance abuse
Concurrent difficulties for ADHD in adulthood
Under-iemplyed
Legal difficulties
A nurse knows that the three core symptoms of ADHD are
Hyperactivity
Inattention
Impulsivity
T/F Children not treated for ADHD are more likely to develop substance abuse disorders in adolescence
True
Causes of ADHD
not clearly understood
Genetic & environmental links
T/F ADD is used to classify ADHD without hyperactivity
FALSE (no longer use this, you can have ADHD with just inattention, or combined ADHD)
T/F ADHD must be diagnosed prior to child's 5th birthday and school entrance
false (Changed diagnostic criteria, used to be this)
T/F you can be diagnosed for ADHD at any age
true
Which of the following is not a diagnostic criteria for ADHD?
A) be present from one of the two categories before age 12 (inattention, impulsivity)
B) Be more severe than the child's peers
C) Be excessive for the developmental level of the child
D) Last f
D (symptoms must last for at least SIX months)
(B is correct b/c it is comparative data, ex. in the play group do you notice your son is more talkative?)
must have symptoms from which 2 categories to be diagnosed with ADHD
Inattention
Hyperactivity/Impulsivity
Brain with ADHD
smaller volume, thinner gray matter (localized in anterior cingulate)
Diagnosis criteria for ADHD
Be present from one of the 2 categories before age 12 yo
(Inattention
Hyperactivity/Impulsivity)
Be more severe than the child's peers
Be excessive for the developmental level of the child
Last for at least 6 months
Occur within and negatively affect at l
Examples of stressors that could cause ADHD like symptoms
Divorce
Move
New baby
Loss of job
T/F you have more symptoms of ADHD at a younger age
TRUE
As part of John's 8 year WCC the nurse inquires about school performance> John's mother states "John is very smart but his teacher says he never turns in his homework and frequently appears to be daydreaming when completing an activity" the nurse's best a
B
6 or more of the following for at least 6 months:
inability to pay attention to details or a tendency to make careless errors in schoolwork or other activities
difficulty with sustained attention in tasks or play activities
apparent listening problems
dif
Inattentive-type ADHD
includes excessive fidgetiness and talking
Difficulty remaining seated and playing quietly
Frequent restlessness
always 'on the go'
Hyperactivity
6 or more of the following for 6 months:
fidgeting or squirming
difficulty remaining seated
excessive running or climbing
difficulty playing quietly
always seeming to be "on the go"
excessive talking
blurting out answers before hearing
the full question
d
Hyperactive-impulsive type
Infant symptoms of ADHD
Crying frequently and difficult to soothe
Poor sleep due to restlessness and over-reactivity
Feeding difficulties with picky eating, poor sucking or crying that interferes with intake
Preschool symptom sof ADHD
Hyperactivity; "driven by a motor"
Insatiable curiosity
Destructive play and injuries
High demands for parental attention
Low compliance
Excessive tantrums
Delays in developmental tasks - motor, language,
Toileting
Decreased and/or restless sleep
Difficul
used by healthcare professionals to help diagnose ADHD in children between the ages of 6 and 12.
Vanderbilt assessment scae
who fills out vanderbilt survey?
parent, one other adult in another environment (ex. teacher)
things vanderbilt assess for
ODD (ex. questions that r/t bullying, anger, defiance)
Depression
ADHD
Anxiety
Fear
The nurse is caring for a patient with ADHD. which medication order should the nurse question
A) Strattera
B) lithium
C) Imipramine
D) Concerta (methyphenidate) stimulant
B (lithium not given for ADHD, indicated for bipolar disorder)
Why is Concerta a hard sell?
Depresses appetite
Can reduce growth
Disrupts sleep
T/F Stimulant drugs are often not approved by parents who don't want to "stimulate their kids anymore
True (but ADHD is caused by under stimulation
? They think ADHD is caused by lack of dopamine activation, so they are "deficient" and this makes them back to normal, body releases more DA and can maintain more attention
Issue: if you DONT have issue and y
Caused by lack of dopamine stimulation
ADHD
A nurse knows that the preferred first line treatment for a 5 year old with ADHD includes
A) behavior modification
B) stimulating medication
C) Inpatient
D) home-based
A (good with medication and behavior modification, medication is NUMBER one go to treatment + behavioral modification)
ADHD medications
abuse potential (in academic settings, esp. if person does not have ADHD)