NURS 414 Psychology Final Review
ADHD
o family dynamics
family is dysfunctional
inattention and neglected during development
poverty
lack of resources
family stress
marital discord
parental substance abuse
o objective signs & subjective symptoms
present before age of 7...
household stability consistency of rules and routines
bupropion wellbutrin
venlafaxine effexor
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NURS 414 Psychology Final Review
❖ ADHD
o family dynamics
❖ family is dysfunctional
❖ inattention and neglected during development
❖ poverty
❖ lack of resources
❖ family stress
❖ marital discord
❖ parental substance abuse
o objective signs & subjective symptoms
❖ present before age of 7 years
❖ present for at least 6 months
❖ hyperactivity
❖ talks excessively
❖ figety or restless
❖ acts as if “driven by a motor”
❖ difficulty playing quietly
❖ leaves seat when expected to remain seated
❖ runs of climbs excessively in inappropriate situations
❖ impulsivity
❖ blurts out answers before a question has been completed
❖ difficulty awaiting their turn
❖ causes frequent interruptions or intrusions
❖ inattentiveness
❖ difficulty sustaining attention during tasks
❖ easily distracted by unrelated stimuli or thoughts
❖ fails to pay close attention to detail
❖ difficulty organizing tasks or activities
❖ appears not to listen when spoken to directly
❖ fails to follow on instructions or finish assigned work
o key assessment data
❖ biologic
,❖ classroom behavior
❖ school performance
❖ teacher evaluation
❖ standardized instruments to measure impulsivity, hyperactivity, inattention
, ❖ development history
❖ medical history
❖ eating patterns
❖ sleeping patterns
❖ activity patterns
❖ psychological
❖ hyperactivity
❖ impulsivity
❖ inattention
❖ discipline issues
❖ difficulty in decision making
❖ social
❖ family situation and interaction
❖ parenting style
❖ household stability
❖ consistency of rules and routines
❖ life event
❖ school performance
o planning care & determining outcomes
❖ management overview:
o CBT
▪ cognitive therapy
▪ behavioral therapy
• token economy – rewarding positive behaviors and punishing negative behaviors
o stimulant drugs
▪ methylphenidate [Ritalin, Concerta]
▪ dexmethylphenidate [Focalin]
▪ dextroamphetamine [Adderall, Dexedrine (60s and 70s)]
▪ amphetamine & dextroamphetamine sulfate combination [Adderall]
▪ pemoline [Cylert]
❖ biologic
❖ interventions
❖ modify nutrition
❖ promote sleep
❖ pharmacological
❖ antidepressants
❖ bupropion [Wellbutrin]
❖ venlafaxine [Effexor]
❖ tricyclic antidepressants
, ❖ imipramine [Tofranil]
❖ desipramine [Norpramin]
❖ notriptyline [Pamelor]
❖ CNS psychostimulants
❖ Amphetamines [Adderall, Dexedrine], methylphenidate [Ritalin],
dexmethylphenidate [Focalin]
❖ Atomoxetine [Strattera]
❖ Alpha-2A agonists
❖ Clonidine [Catapres], guanfacine [Intuiv XR]
❖ Psychological
o behavioral programs – nonpharmacological method
▪ token economy
➢ rewards for positive behavior
➢ consequences for negative behavior
o cognitive behavioral techniques
• clear limits with clear consequences
• predictable environment with decreased stimuli
• one assignment at a time
• calm environment with few stimuli
• homework in a quiet place
• eye contact before giving directions about limits and consequences
• ask to repeat what was heard
❖ social
❖ family treatment
❖ parent training
❖ school programming
❖ specific remediation
❖ comorbid deficits in learning or language
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