1. The client/caregiver can define attention deficit hyperactivity disorder (ADHD).
   1. It is a persistent pattern of inattention and/or hyperactivity and impulsivity that is more frequently displayed and more severe than the typical individual.
   2. Condition continues into adulthood.
   3. It seems to run in families.
   4. The three types of ADHD are
      • Predominantly inattentive
      • Predominantly hyperactive/impulsive
      • Combination
2. The client/caregiver can list symptoms of ADHD.
   1. Symptoms for inattention
      • Often fails to pay attention to details
      • Often makes careless mistakes
      • Often does not listen when directly spoken to
      • Often does not follow instructions and fails to finish activities, schoolwork, chores, or duties in the workplace
      • Often has difficulty organizing tasks and activities
      • Often avoids or dislikes tasks that require ongoing mental effort or concentration
      • Often loses important things
      • Often is easily distracted by unimportant things
      • Often moves hands and feet nervously or squirms
      • Often leaves the seat when staying seated is expected
      • Often feels restless
      • Often cannot be involved in leisure activities quietly
      • Often talks too much or too fast
   2. Symptoms for hyperactivity
      • Often moves hands and feet nervously or squirms
      • Often leaves the seat when staying seated is expected
      • Often feels restless
      • Often cannot be involved in leisure activities quietly
      • Often talks too much or too fast
   3. Symptoms of impulsivity
      • Often blurts out answers before questions are fully asked
      • Often has a hard time awaiting turn
      • Often butts in on others’ conversations or activities
      • Ongoing, strong feelings of frustration, guilt, or blame
3. The client/caregiver can list measures to help manage ADHD.
   1. Medication and behavior therapy are used to treat ADHD in both children and adults.
   2. Basic principles to help children cope with ADHD:
      1. Set specific goals—primarily timed goals.
      2. Provide rewards and consequences.
      3. Consistently use rewards and consequences, but adjust to age and situation.
      4. Reward positive behavior. Positive behavior in reaching a goal in a timely manner or good behavior, such as paying attention, should always be praised.
      5. Calmly discipline with time-outs, distraction, and so forth. Discuss unwanted behavior when calm.
      6. Inform teachers, coaches, and so forth of treatment and plan.
      7. Child will learn skills to monitor their behavior as they mature.
   3. Management and coping skills for people with ADHD of any age are
      1. Arrange daily schedule for activities. Remain consistent.
      2. Cut down on distractions. Loud music, television, and so forth can overstimulate when trying to do homework. At work, develop measures that help you focus, such as closing the office door; and limit phone calls to specific times. Keeping the desk organized and clean.
      3. Organize and have specific places to keep items.
      4. Break projects into smaller parts to avoid feeling overwhelmed.
      5. Use charts, checklists, and so forth to track progress.
      6. Make yourself brief notes regarding details, instructions, schedules, and so forth.
      7. Limit choices to only two or three options at a time.
      8. Find activities that you like and can be successful doing.
      9. Use any tools that help you stay organized.
      10. Get exercise, and eat a balanced diet. Some medications can alter appetite.
      11. Practice relaxation techniques.
4. The client/caregiver can list possible consequences of untreated ADHD.
   1. Children with ADHD have more injuries and falls, resulting in emergency room visits.
   2. Adolescents with ADHD are more likely to engage in risky behaviors.
      • Substance abuse
      • Unprotected sexual activity leading to sexually transmitted diseases and teen pregnancy
      • More speeding tickets and involvement in auto accidents
   3. Adolescents and young adults are more likely to drop out of school.
   4. Adults with ADHD are
      • More likely to suffer from depression and anxiety
      • More likely to be fired from jobs or change jobs frequently
      • More likely to get divorced or failed relationships
   5. People of all ages with ADHD often have poor self-esteem and are told they are lazy, not trying, and so forth because they perform as underachievers. They have ongoing, strong feelings of frustration, guilt, or blame.

Resource

Support groups

ADHD coach

Children and Adults with Attention-Deficit/Hyperactivity Disorder
800-233-4050
www.chadd.org

Attention Deficit Disorder Association
www.add.org

Learning Disabilities Association of America
www.ldaamerica.org

National Center for Learning Disabilities
www.ld.org

National Institute of Mental Health
www.nimh.nih.gov

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. Philadelphia: Mosby Inc.
Hitchcock, J. E., Schubert, P. E., & Thomas, S. A. (2003). Community health nursing: Caring in action. Clifton Park, NY: Thomson Delmar Learning.
Muscari, M. E. (2005). Pediatric nursing. Philadelphia: Lippincott Williams & Wilkins.
Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. Lippincott Williams & Wilkins.
Varcarolis, E. M. (2006). Manual of psychiatric nursing care plans. St. Louis: Saunders Elsevier.

Credits

Client Teaching Guides for Home Health Care, 2nd ed.
© 2008 Jones and Bartlett Publishers, Inc.
www.jbpub.com