attention-deficit & disruptive disorders
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8/13/2019 Attention-Deficit & Disruptive Disorders
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Attention-Deficit &
Disruptive Disorders
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ADHD
Attention DeficitHyperactivity
Disorder
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Persistent pattern of inattention and orhyperactivity-impulsiveness revealed before
the age of 7 years Occurs in 3 to 7 % of school-age children inUS
Boys > girls Idiopathic
Genetic etiologic component Assoc with child neglect Lead poisoning Drug exposure in utero
http://www.google.com.ph/url?sa=i&rct=j&q=adhd&source=images&cd=&cad=rja&docid=hNYxmoNKPl8JWM&tbnid=tvfcykL2WAdxzM:&ved=0CAUQjRw&url=http://www.adhd.org.nz/&ei=OagvUcX8OIaZiAfblIG4Bg&psig=AFQjCNF3j7ApWhoJ5EfHuSh0UK2RYPUAXQ&ust=1362164144865926http://www.google.com.ph/url?sa=i&rct=j&q=adhd&source=images&cd=&cad=rja&docid=hNYxmoNKPl8JWM&tbnid=tvfcykL2WAdxzM:&ved=0CAUQjRw&url=http://www.adhd.org.nz/&ei=OagvUcX8OIaZiAfblIG4Bg&psig=AFQjCNF3j7ApWhoJ5EfHuSh0UK2RYPUAXQ&ust=1362164144865926 -
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Characterized by 3behaviors:
INATTENTION
IMPULSIVENESS
HYPERACTIVITY
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Assessment
Diagnosable by 36 months of age
Behavior: active or always on the go
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HyperactivityNot able to sit still long enough tofinish a full meal
Running to the window 10 times in 15minutes
Disorganized activity: running fromback of the room to the front, to the
teachersdesk to their own desk
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Repetitive activitiesPencil tapping
Arm swinging
Finger tapping
Leaves an activity intently and runto the window or refrigerator
unaware of why they are running
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VariabilityHave good and bad moments
Lose track of systems
Poor school performance
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Impulsiveness
Make statements without thinking
Touch objects theyre not allowedto speak and act before they think
all or none reaction to stimuli
Cant concentrate on problem athand
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Difficulty with right & left, before & after, infront of, in back of and yesterday andtomorrow
Difficulty forming common letters b & d Difficulty using prepositions and conjunctions
correctly Difficulty to read Difficulty in arithmetic Spelling is difficult
W/O INTELLIGENCE DEFICIT
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PE: Inability to use pencil and scissorswell
NEUROLOGIC EXAMINATIONw/o Difficulty performing finger-to-nose test, rapid hand movementsmirroring
Cerebellar difficultyIdentify one touch but not 2simultaneous touch
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Not normal:GrapesthesiaStereognosis
Choreiform movements
Unilateral babinski reflex orstrabismus
Scatter pattern on performance
and verbal portions
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ADHD Diagnostic Evaluation
Physical examination
Parent-rated child behavior scales
Teacher-rated child behavior scales
Parent and child interviews Parent self report measures
Parent self-report measures
Clinic-based psychological test
Review of prior school and medical reports Intelligence testing (IQ tests) and
educational achievement testing
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Possible Nursing Diagnosis
Impaired Social Interaction: Insufficient orexcessive quantity or ineffective quality ofsocial exchange.
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Therapeutic Management
EnvironmentStable learning environmentSpecial schooling Free of stimulating distractionsBe firm, set consistent limitsOffer choices for the childAssist children to reach the point of thestory
Punishment should follow an offensequickly
Poor self esteem
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Medication Methylphenide hydrochloride (Ritalin)
Family Support
Frequent health visitsFrequent health visits
Responsive, listening ear
Close parental supervision
Caution against accidents e.g. burns
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