boitnott (L24) ADHD

Marked by


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


Epidemiology of ADHD


Concurrent difficulties with ADHD in childhood

Academic underachievement

Concurrent difficulties for ADHD in adolescence

Motor vehicle accidents
low self esteem
Smoking/substance abuse

Concurrent difficulties for ADHD in adulthood

Legal difficulties

A nurse knows that the three core symptoms of ADHD are


T/F Children not treated for ADHD are more likely to develop substance abuse disorders in adolescence


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


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


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
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

New baby
Loss of job

T/F you have more symptoms of ADHD at a younger age


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


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

Inattentive-type ADHD

includes excessive fidgetiness and talking
Difficulty remaining seated and playing quietly
Frequent restlessness
always 'on the go'


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

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,
Decreased and/or restless sleep

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)

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


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)