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ADHD (best)]

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  • Excellent posting! You might appreciate this additional set of criteria on the biomedical side:
    http://slidesha.re/1aLiWuA
    cp
    Author: New ADHD Medication Rules - Brain Science & Common Sense
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  • 1.  
  • 2.
    • Introduction
    • Causes
    • Diagnose (S&S)
    • Epidemiology
    • Treatment
    • Research and current study
    • Disease across life span
    • Nursing Care
    • Summary
    • References
  • 3.
    • Termed: Attention deficit, hyperactivity disorder
    • ADD is no different from ADHD but it refers to adults in the Diagnostic & Statistical Manual for Mental Disorders (DSM-IV-TR)
    • ADHD is a diagnosis applied to children and adults who consistently display certain behaviors such as distractibility, impulsivity, and hyperactivity over a period of time.
  • 4.
    • Myth: ADHD is caused by bad parenting.
    • Myth: Children who have ADHD will eventually grow out of it.
    • Myth: ADHD is not a medical condition.
    • Fact: ADHD is a neurobehavioural disorder
    • Fact: 80% of children who have ADHD will continue to have enough symptoms to qualify for diagnosis as an adolescent and over 60% of adults will maintain core symptoms of ADHD.
    • Fact: ADHD is a biological brain based condition officially recognized by leading medical experts and institutions
  • 5.
    • Specific cause is unknown
    • Twin studies showed that 75% of ADHD cases are genetically inherited
    • Twin studies also suggested that 9-20% is also due to environmental factors
      • Pregnancy: smoking, alcohol, and premature birth
    • Diet: European Food and Safety Authority (EFSA) conclude in their study that food additive such as artificial food coloring and preservative significantly affects children with ADHD
    http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/what-causes-adhd.shtml
  • 6.
    • Dopamine: research study suggests that various genes affect the neurotransmitter dopamine:
      • Dopamine activation is a reward for the brain
      • ADHD individuals dopamine receptors are not as efficient as a normal person’s therefore they have a lower dopamine level
  • 7.
    • Delayed in frontal and temporal lobe
    • Accelerated maturity of the motor cortex
    • SPECT shows reduce circulation
    • Pet Scan shows a decrease glucose metabolism during activity
  • 8.  
  • 9.
    • DSM-IV Criteria for ADHD I. Either A or B:
    • A. 6 or more of the following symptoms of inattention have been present for at least 6 months to a point that is disruptive and inappropriate for developmental level:
    • Inattention : poor attention to detail, keeping up with tasks, doesn’t listen when spoken to, forgetful, easily distracted, avoid things that take effort to perform, lose things needed for a task, often does not follow instructions
    http://www.cdc.gov/ncbddd/adhd/symptom.htm
  • 10.
    • DSM-IV Criteria for ADHD
    • B. Six or more of the following symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for developmental level:
    • Hyperactivity: Often fidgety or squirms in seat, often runs about or climbs when and where it is not appropriate, act loudly, driven (always on the go), often talks excessively.
  • 11.
    • Impulsivity
    • blurts out answers before questions have been finished
    • trouble waiting one's turn.
    • interrupts or intrudes on others
    • Some symptoms that cause impairment were present before age 7 years.
    • Some impairment from the symptoms are present in two or more settings (e.g. at school/work and at home).
    • There must be clear evidence of significant impairment in social, school, or work functioning.
  • 12.  
  • 13.
    • Based on the these criteria, three types of ADHD are identified:
    • 1. ADHD, Combined Type : if both criteria A and B are met for the past 6 months.
      • Tigger type-Hyperactive, restelessness, disorganized, inattention, impulsivity
  • 14.
    • 2. ADHD, Predominantly Inattentive Type : if criterion A is met but criterion B is not met for the past six months
      • Pooh type- Inattentive, sluggish, slow-moving, unmotivated, daydreamer
  • 15.
    • 3. ADHD, Predominantly Hyperactive-Impulsive Type : if Criterion B is met but Criterion A is not met for the past six months.
    • Rabbit Type- over focused, obsessive, argumentative
  • 16.
    • developmental disorder
    • behavior disorder
    • disruptive behavior disorder
    • oppositional defiant disorder
    • conduct disorder
    • antisocial disorder
  • 17.
    • Preschool- Disruptive behavior, aggression towards other children, hyperactivity, conduct problems, inattentive and overactive
    • Middle Childhood- Unfinished tasks (unfinished games, uncovered toothpaste), trouble with school work, criticism from parents/teachers/peers, low self esteem. Depression and conduct disorders can develop here.
  • 18.
    • Adolescence- higher rates of anxiety, depression, oppositional behavior, social failure, substance abuse
    • Adulthood- trouble at work, relationships, difficulty following directions, remembering, and concentrating, emotional and social problems
  • 19.
    • CDC estimates 4.4 million youth ages 4-17 have been diagnosed with ADHD
    • In 2003, 2.5 million youth ages 4-17 are currently receiving medication treatment for the disorder.
    http://www.cdc.gov/ncbddd/ADHD/
  • 20. http://www.cdc.gov/ncbddd/ADHD/adhdprevalence.htm
  • 21. http://www.cdc.gov/ncbddd/ADHD/adhdmedicated.htm
  • 22.
    • treatment focuses on reducing the symptoms of ADHD and improving functioning through medications, behavioral therapies, and psycho therapy.
  • 23.
    • Most are treated with stimulant but non-stimulants are also used
    • Medication help to improve focus, thinking, ability to learn and work
    • It also reduces symptoms of hyperactivity, impulsivity, and inattention
    http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/medications.shtml
  • 24. http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/medications.shtml
  • 25.
    • Goal: change/monitor child behaviors
    • Intervention includes:
    • practical assistance with organizing tasks or completing schoolwork, or working through emotionally difficult events
    • allow child to give oneself praise or rewards for acting in a desired way
    • Parents and teachers also can give positive or negative feedback for certain behaviors.
    • Set clear rules, chore lists, and other structured routines can help a child control his or her behavior
    http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/psychotherapy.shtml
  • 26.
    • Carbohydrate/Protein-balanced Diet
    • Management of Food Sensitivities in ADHD Patients
    • Nutritional Supplementation for ADHD
    • Mineral Deficiencies in ADHD
    • Essential Fatty Acids May Be Deficient in ADHD
    • Disturbances in Amino Acid Metabolism in ADHD
    • Heavy-Metal Toxicity in ADHD
    http://www.healing-arts.org/children/ADHD/treatments.htm
  • 27.
    • Schedule . Keep the same routine every day, from wake-up time to bedtime. Include time for homework, outdoor play, and indoor activities. Keep the schedule on the refrigerator or on a bulletin board in the kitchen. Write changes on the schedule as far in advance as possible.
    • Organize everyday items . Have a place for everything, and keep everything in its place. This includes clothing, backpacks, and toys.
    • Use homework and notebook organizers . Use organizers for school material and supplies. Stress to your child the importance of writing down assignments and bringing home the necessary books.
    • Be clear and consistent . Children with ADHD need consistent rules they can understand and follow.
    • Give praise or rewards when rules are followed . Children with ADHD often receive and expect criticism. Look for good behavior, and praise it.
    http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/psychotherapy.shtml
  • 28.
    • NIMH
    • MTA – complete,
    • Purpose: evaluate the leading treatments for ADHD, including various forms of behavior therapy and medications
    • PATS - complete
    • The study found that low doses of the stimulant methylphenidate are safe and effective for preschoolers but requires monitoring due to side effects
    http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/what-efforts-are-under-way-to-improve-treatment.shtml
  • 29.
    • Efficacy of Concerta in Treating ADHD in Mothers of Children With ADHD
    • - involves trial of Concerta™ methylphenidate for mothers & children with ADHD
    • - purpose: assess the efficacy of Concerta™ in improving adult ADHD symptoms and impairments
    • - The researchers hypothesize that Concerta™ will significantly decrease mothers ADHD symptoms and impairment, as well as improve observed and reported parenting
    http://clinicaltrials.gov/ct2/results?term=ADHD
  • 30.
    • Study of Atomoxetine and OROS Methylphenidate to Treat Children and Adolescents Ages 6-17 With ADHD
    • - purpose: is to evaluate the safety, effectiveness, and tolerability of atomoxetine and OROS methylphenidate, taken together, in the treatment of ADHD in children and adolescents ages 6-17
    http://clinicaltrials.gov/ct2/results?term=ADHD
  • 31.
    • Expected outcomes:
      • Disruptive and dangerous behavior minimized or eliminated
      • The pt will be able to function in a structured learning environment
      • Parent’s will be able to cope with stress and feelings and intervene effectively
  • 32.
      • Interventions:
      • The nurse will:
      • Teach close communication between parent, child, and teacher and assess needs.
      • Refer to a psychologist, counselor, social worker, tutor
      • Facilitate child’s achievement of more consistent behavioral self control
      • Promote parents’ development of coping
  • 33.
    • http://www.youtube.com/watch?v=EJNu5eUJO04
  • 34.
    • (2009). ADHD Across the Lifespan. Retrieved February 15, 2009, from myADHD.com Web site: http://www.myadhd.com/adhdacrosslifespan.html
    • (2008). ADHD Screening Test. Retrieved February 15, 2009, from ScribD Web site: http://www.scribd.com/doc/2281389/ADHD-Screening-Test-PDF
    • (2007). NCP Attention Deficit / Hyperactivity Disorder ADHD . Retrieved February 15, 2009, from Nursing Care Plan Web site: http://nursingcareplan.blogspot.com/2007/05/ncp-attention-deficit-hyperactivity.html
    • Goodman, Gordon (2008). Bugs, Taz, and ADHD. Retrieved February 15, 2009, from You Tube Web site: http://www.youtube.com/watch?v=EJNu5eUJO04
    • (January 23, 2009). What Cause ADHD? Retrieved Febraury 15, 2009 from NIMH. Website: http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/what-causes-adhd.shtml
    • (September 20 th , s005). ADHD. Retrieved February 15, 2009 from CDC. Website: http://www.cdc.gov/ncbddd/adhd/symptom.htm
    • (September 20 th , s005). ADHD. Retrieved February 15, 2009 from CDC. Website: http://www.cdc.gov/ncbddd/ADHD/
    • (January 23, 2009). What Cause ADHD? Retrieved Febraury 15, 2009 from NIMH. Website: http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/medications.shtml
    • (January 23, 2009). What Cause ADHD? Retrieved Febraury 15, 2009 from NIMH. Website: http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/psychotherapy.shtml
    • (January 23, 2009). What Cause ADHD? Retrieved Febraury 15, 2009 from NIMH. Website: http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/psychotherapy.shtml
    • http://clinicaltrials.gov/ct2/results?term=ADHD
    • (February 12, 2009). Efficacy of Concerta in Treating ADHD in Mothers of Children With ADHD. Retrieved february 15, 2009 from clinicalTrial.gov. Website: http://clinicaltrials.gov/ct2/show/NCT00318981?term=ADHD&rank=4