ADHD Case Study

What information is important for the RN to obtain about Joe’s accidents?
Explanation of previous accidents; Precipitating events to the accidents (relates to impulsiveness); What Joe means by the word accident; Has Joe intentionally tried to harm himself.
What are HALLMARK characteristics of ADHD? SATA
Pattern of impulsiveness; Interruptive and intrusive in peers’ games.
The nurse recognizes which statement by Joe supports his diagnosis of ADHD?
I get bored easily
When his laceration is treated he says he knows he is clumsy and wishes there was a pill for that. Which is the best response?
Acknowledge the client’s frustration
Nurse recommends Joe see his PCP. PCP refers Joe to mental health provider. The nurse recognizes which statement by Joe supports his previous diagnosis of ADHD?
I quickly break up with log of girlfriends.
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What activities should the nurse recognize as having a high priority in a safety assessment for Joe? SATA
History of MV violations; Recreational activities; Sexual activity; Drug and etoh use;
Which issue should the nurse assign the highest priority in Joe’s problem list?
At risk for injury.
Which nursing interventions should the RN implement to meet Joe’s biopsychosocial needs? SATA
Printed handouts; Internet resources
Joe thought he was only going to start medications. How should the nurse respond?
Treatment involves more than taking medication.
What are important biological parameters for the nurse to assess after a client has started taking concerta? SATA
Painful and prolonged erection; blood pressure and heart rate; numbness in fingers and toes; weight
Given joe’s inattentiveness and short attention span, what is the most important strategy for the nurse to use when planning care?
Interventions should be time-limited.
Which nursing diagnosis should the nurse address when planning for Joe’s care?
Impaired social interaction related to poor communication skills.
Teaching plan for concerta includes: SATA
Abuse may lead to dependence; is a controlled substance;
Joe asks the nurse when he should take the medication.
In the morning. concerta 54mg is an ER tablet that is taken one time daily in the morning
Joe’s mother says it will be hard for Joe to remember to take the mediation. Who should the nurse respond?
The person taking the medication has to be responsible for taking it correctly.
Joes mom wants to know of other meds to treat ADHD. How should the nurse respond?
Stimulants are the gold standard for treating ADHD
Which problem has priority for the nurse when helping Joe improve his communication skills?
Intrusiveness (and interrupting other is a common trait among ADHD.)
What interventions should the nurse implement to improve self-esteem SATA
Encourage Joe to list 3 of his positive attributes; Practice attentive listening when Joe is talking.
The nurse can measure improvement in Joe’s social skills by which statement?
I have had the same girlfriend for 6 months now.
When assessing Joe for improvement in his self-esteem, what is the best approach for the nurse to use?
Tell me about the things that have improved this semester.
Joe tells the nurse that he has experienced changes in the effectiveness of his medication. How should the nurse respond to Joe’s comment?
What changes are of concern to you?
Joe advises he is having difficulty falling asleep. What is the first behavior the nurse should ask about when assessing?
Medication schedule.
Joe inquires if he will need to take medication for the rest of his life. How should the nurse respond?
Psychotherapy that focuses on ADHD may help eliminate medication.
what should the nurse assess at Joe’s follow up visit? SATA
Nutritional status; Mood/anxiety disorders; coping mechanisms.
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