Understanding ADHD: Symptoms and Management

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is a key requirement for diagnosing a child with ADHD?

Evidence of social and academic impairment (correct)

A minimum of 4 symptoms from each category

Presence of symptoms for at least two years

Symptoms occurring before the age of 4

Which of the following is NOT a common symptom of ADHD?

Fidgeting and failing to remain seated

Avoiding activities that require mental effort

Always completing tasks ahead of schedule (correct)

Difficulty sustaining attention

What is an important aspect of managing ADHD with medication?

Increasing the dosage based on behavioral observations

Administering medication at bedtime to aid sleep

Giving medication only during school hours

Monitoring for potential side effects like hypertension (correct)

When implementing behavioral management strategies for a child with ADHD, it is essential to:

Obtain the child's attention before giving directions Signup and view all the answers

Which of the following medications is commonly prescribed for ADHD?

Methylphenidate Signup and view all the answers

Which of the following symptoms are primarily associated with Attention Deficit Hyperactivity Disorder (ADHD)?

Inattention, hyperactivity, and impulsiveness Signup and view all the answers

At what age is ADHD usually revealed in children?

Prior to age 7 Signup and view all the answers

Which of the following conditions is associated with increased intracranial pressure (ICP)?

Hydrocephalus Signup and view all the answers

What is a potential complication of a ventriculoperitoneal shunt?

Infection Signup and view all the answers

Which type of cancer is specifically listed in the study guide as a consideration in pediatrics?

Nephroblastoma Signup and view all the answers

Which intervention is crucial to prevent increase of intracranial pressure (ICP) during assessment?

Position the client so that the head is maintained midline Signup and view all the answers

What immediate action should be taken if signs of increased intracranial pressure are observed?

Notify the healthcare provider (HCP) Signup and view all the answers

Which of the following is a sign that could indicate shunt malfunction in older children?

Persistent headache Signup and view all the answers

What should be done to assess for cerebrospinal fluid (CSF) drainage from nares or ears?

Test for glucose in the drainage Signup and view all the answers

Which of the following is a pre-operative intervention for a child undergoing shunt placement?

Prepare the family for the procedure Signup and view all the answers

After shunt placement surgery, how should the child be positioned to prevent pressure on the shunt valve?

On the unoperated side Signup and view all the answers

What is a common complication that requires monitoring after ventriculoperitoneal shunt surgery?

Paralytic ileus Signup and view all the answers

What is the most important reason to maintain the patient NPO before surgery?

To prevent aspiration during anesthesia Signup and view all the answers

What indicates meningeal irritation in a child?

Pain or resistance with hip and knee flexion Signup and view all the answers

Which laboratory finding is NOT typically expected in a lumbar puncture for meningitis?

Normal color of CSF Signup and view all the answers

What is the priority intervention in a child suspected of having meningitis?

Administer antibiotics Signup and view all the answers

Which clinical presentation is a common sign of hydrocephalus?

Separation of cranial sutures Signup and view all the answers

What is vital to measure for the assessment of a child with hydrocephalus?

Head circumference Signup and view all the answers

Which factor increases the risk for developing Acute Lymphoblastic Leukemia (ALL)?

Down syndrome Signup and view all the answers

What is a classic manifestation of leukemia in children?

Petechiae Signup and view all the answers

What specific intervention is involved in the care of children undergoing chemotherapy for leukemia?

Frequent mouth care Signup and view all the answers

What clinical finding suggests increased intracranial pressure (ICP) in a child?

Bulging fontanel Signup and view all the answers

Which diagnostic tool is NOT typically used in diagnosing hydrocephalus?

X-ray Signup and view all the answers

What is the primary reason for frequent blood glucose monitoring in patients using subcutaneous insulin?

To check before meals and at bedtime Signup and view all the answers

Which symptom is characteristic of Type 2 diabetes?

Acanthosis nigricans Signup and view all the answers

What is the first approach to managing Type 2 diabetes in children?

Diet and exercise Signup and view all the answers

Which of the following is a potential complication from poor management of diabetes in children?

Long-term vascular complications Signup and view all the answers

How does metformin function in the treatment of Type 2 diabetes?

It improves the body's sensitivity to insulin Signup and view all the answers

What factor is believed to contribute to the onset of Type 2 diabetes during puberty?

Hormonal changes requiring more insulin Signup and view all the answers

How can hematology assist in the diagnosis of hemophilia?

By assessing clotting factor levels Signup and view all the answers

What is one of the diagnostic assessments for Type 2 diabetes?

Islet cell autoantibodies testing Signup and view all the answers

Study Notes

Attention Deficit Hyperactivity Disorder (ADHD)

ADHD is characterized by inattentiveness, hyperactivity, and impulsiveness, typically appearing before age 7.
Diagnosis requires:
- Manifestations present between ages 4-18
- Social and academic impairment
- 6 or more findings from a category
Symptoms include:
- Inattentiveness: difficulty paying attention, sustaining focus, following instructions, organizing activities, completing tasks, losing things, and being forgetful.
- Hyperactivity: fidgeting, excessive movement, difficulty sitting still, restlessness, and talking excessively.
- Impulsivity: blurting out answers, interrupting, difficulty waiting turns, acting before thinking.
Management includes:
- Medications: CNS stimulants (methylphenidate or dextroamphetamine) given 30 minutes before meals, early in the day to prevent insomnia. Monitor for side effects like anorexia, hypo/hypertension, tachycardia, and anemia.
- Behavioral Therapy: modeling acceptable behavior, gaining attention before giving directions, setting clear limits, and positive reinforcement.

Child Maltreatment

Maltreatment is any act or failure to act that results in harm to a child.
Types of maltreatment include: physical abuse, neglect, sexual abuse, and emotional abuse.
Signs of maltreatment can be physical, behavioral, or emotional.

Mental Health

Autism is a neurodevelopmental disorder characterized by deficits in social communication and interaction, repetitive behaviors, and restricted interests.
- Symptoms: delayed language development, difficulty with social interaction, repetitive behaviors, and sensory sensitivities.
- Management: early intervention, behavior therapy, and special education services.

Hydrocephalus

Hydrocephalus is a buildup of cerebrospinal fluid (CSF) within the brain.
Typically involves a blockage of CSF flow.
Clinical presentation:
- Increased Intracranial Pressure (ICP): including bulging fontanels, dilated scalp veins, pale scalp skin, and separation of cranial sutures.
- Macewen's sign: tapping on the skull produces a resonant sound.
- Difficulty holding the head upright, frontal bossing, sunset eyes, and bulging fontanels.
- Nausea, vomiting, headaches, irritability, lethargy, decreased school performance, and gait disturbances.
Diagnosis:
- Prenatal ultrasound
- Physical assessment (increased head circumference)
- CT scan or MRI
- Cisternogram to identify abnormalities in CSF flow.
- Lumbar puncture is contraindicated.
Management:
- Relieving ICP
- Placement of a ventriculoperitoneal (VP) shunt
- Regular head circumference measurements

Oncology

Leukemia is cancer of the blood-forming tissues in the bone marrow.
- Acute Lymphoblastic Leukemia (ALL):
  - 20% lymphoblasts (immature white blood cells)
  - Rapid production of abnormal white blood cells in the bone marrow
  - Manifestations: petechiae, hepatosplenomegaly, lymphadenopathy, high fever, fatigue, night sweats, bone and joint pain, loss of appetite, nasal congestion.
  - Labs/Diagnostics: low WBC, RBC, platelets, increased lymphoblasts (>20%), bone marrow biopsy, lumbar puncture, ECG, EEG, FACES pain scale.
  - Treatment: central venous catheter (CVC) placement, chemotherapy, mouth care every 4 hours to prevent sores (nystatin, chlorhexidine), encourage play as tolerated.
Hodgkin's lymphoma is a type of cancer that affects the lymphatic system.
- Symptoms: painless swelling of lymph nodes, fatigue, fever, night sweats, and weight loss.
- Treatment: chemotherapy, radiation therapy, and bone marrow transplant.
Nephroblastoma is a kidney cancer that occurs in children.
- Symptoms: abdominal mass, pain, fever, weight loss, and hematuria.
- Treatment: surgery, chemotherapy, and radiation therapy.

Other

Bacterial meningitis is a serious infection of the membranes that surround the brain and spinal cord.
- Symptoms: fever, headache, stiff neck, nausea, vomiting, sensitivity to light, and altered mental status.
- Treatment: antibiotics administered intravenously.
Ventriculoperitoneal Shunt is a surgical procedure to drain CSF from the brain into the peritoneal cavity.
- Indication: hydrocephalus, increased ICP.
- Pre-op interventions: monitor I & O, small, frequent feedings until NPO status, reposition head frequently, prepare patient and family for procedure, obtain baseline head circumference and abdominal circumference.
- Post-op interventions: monitor vital signs and neurological status, position on unoperated side, keep child flat if prescribed, observe for signs of increased ICP, measure head circumference, monitor for signs of infection, and assess dressings for drainage.
Iron Deficiency Anemia is a condition characterized by low levels of iron in the blood.
- Symptoms: fatigue, weakness, pale skin, shortness of breath, and headaches.
- Treatment: iron supplements.
Sickle Cell Anemia is a genetic disorder characterized by the production of abnormal red blood cells.
- Symptoms: pain, fatigue, shortness of breath, jaundice, and delayed growth.
- Treatment: pain management, blood transfusions, and medication to prevent complications.
Diabetes Type 1 is an autoimmune disorder characterized by the destruction of the insulin-producing cells in the pancreas.
- Symptoms: excessive thirst, frequent urination, increased hunger, unexplained weight loss, fatigue, blurred vision.
- Treatment: insulin injections, diet, and exercise.
Diabetes Type 2 is a chronic condition characterized by the body's inability to use insulin properly.
- Symptoms: similar to type 1, but often develop more slowly and are less severe.
- Treatment: diet, exercise, and oral medications to improve insulin sensitivity.
Hypothyroidism is a condition characterized by the underproduction of thyroid hormones.
- Symptoms: fatigue, weight gain, constipation, dry skin, cold intolerance, and depression.
- Treatment: thyroid hormone replacement therapy.
Cushing's disease is a condition characterized by the overproduction of cortisol.
- Symptoms: weight gain, moon face, buffalo hump, easy bruising, high blood pressure, and diabetes.
- Treatment: medication to lower cortisol levels, surgery, or radiation therapy.
Addison's disease is a condition characterized by the underproduction of cortisol and aldosterone.
- Symptoms: fatigue, weakness, weight loss, low blood pressure, and darkening of the skin.
- Treatment: hormone replacement therapy.
Anorexia nervosa is an eating disorder characterized by an intense fear of gaining weight, a distorted body image, and severe food restriction.
- Symptoms: extreme weight loss, obsessive thoughts about food and weight, and amenorrhea.
- Treatment: psychotherapy, nutritional counseling, and sometimes medication.
Thrombocytopenia is a condition characterized by a low platelet count.
- Symptoms: easy bruising, bleeding gums, and nosebleeds.
- Treatment: medication to increase platelet production, blood transfusions, and sometimes surgery.
HIV is a virus that weakens the immune system.
- Symptoms: flu-like symptoms, swollen lymph nodes, and opportunistic infections.
- Treatment: antiretroviral therapy to manage the virus.
SIADH and DI are both conditions that affect the body's fluid balance.
- SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion): characterized by excessive production of antidiuretic hormone (ADH), leading to fluid retention.
- DI (Diabetes Insipidus): characterized by a deficiency of ADH, leading to excessive urination.
Hemophilia is a genetic bleeding disorder caused by a deficiency in certain clotting factors.
- Symptoms: prolonged bleeding after injuries or surgery.
- Treatment: replacement of the missing clotting factor.
Palliative care is an approach to care that focuses on relieving suffering and improving quality of life for individuals with serious illnesses.
Chemotherapy is a type of cancer treatment that uses drugs to kill cancer cells.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz explores the characteristics, diagnosis, and management of Attention Deficit Hyperactivity Disorder (ADHD). Learn about the symptoms of inattentiveness, hyperactivity, and impulsivity. Understand the requirements for diagnosis and the role of medications and behavioral therapy in managing this condition.