Attention Defecit Hyperactivity Disorder ADHD Attention Defecit Hyperactivity Disorder Lindsay Grissett NUR 4120

WHY ADHD? I chose ADHD because I was diagnosed with ADHD when I was nineteen years old. However, I feel that in many young children it is over diagnosed because parents feel that their child is too hyper. The pediatrician I had as a child did not believe in ADHD, which is why I was not diagnosed until I was older. I fully believe that ADHD is a hereditary disorder, because my father has some of the same issues concentrating and impulsivity I had before I was diagnosed.

Attention defecit hyperactivity disorder ADHD is characterized by poor attention span, behavior control problems, and/or hyperactivity. ADHD is most often diagnosed in childhood but can be diagnosed in adulthood, also.

Pathophysiology The pathophysiology of ADHD is not clearly understood. Medications that are used to treat ADHD have led researchers to speculate that areas of the brain related to attention are deficient in neural transmission. The underlying brain regions predominantly thought to be involved are frontal lobe and prefrontal; the parietal lobe and cerebellum may also be involved. Recent studies with PET scan imaging and MRIs have shown that structural and functional alterations that were originally thought to have been in the frontostriatal circuitry are now more prominent in the cerebellum and parietal lobes.

RISK FACTORS Blood relatives with ADHD or another mental disorder Maternal drug, alcohol, or cigarette smoking during pregnancy Exposure to environmental toxins, such as lead Premature birth Maternal exposure to poisons during pregnancy Sugar is often considered a source a hyperactivity in children, but this is not a contributing factor in ADHD.

Clinical manifestations Easily distracted Failure to receive and follow directions Inability to focus on one task at a time Jumping from one activity to another Difficulty remembering Frequent loss or misplacement of items Excessive talking and interrupting others Inability to sit still Impulsiveness Sleep disturbance

Diagnostic tests According to the Mayo Clinic, there's no specific test for ADHD, but making a diagnosis will likely include: Medical exam, to help rule out other possible causes of symptoms Information gathering, such as any current medical issues, personal and family medical history and school records Interviews or questionnaires for family members, the child's teachers or other people who know the child well, such as baby sitters and coaches ADHD rating scales to help collect and evaluate information

pharmacotherapy ADHD is treated by CNS stimulants. Stimulants reverse many of the symptoms, helping patients focus on tasks. Some examples of medications are: Adderal, Focalin, and Vyvanse.

Evidence based practice Our textbook had an awesome example of an EBP question on page 204: should cardiovascular risk be considered in the decision to use ADHD medication? Evidence: With a black box warning for increased risk of cardiovascular events caused by traditional drug therapy for ADHD, health care providers may reconsider the use of these drugs and parents may be concerned about their use. Although the events are rare, the FDA found cause for the warnings. Elia and Vetter (2010) investigated the risk and also the availability of screening tools for detecting cardiac disease. The study found that highest risk occurred while exercising, and baseline EKG prior to and during exercise may help to screen for previously undetected cardiac disease. On a personal note, I wanted to add that I was not diagnosed with mitral valve prolapse with regurgitation until I was twenty one. I feel that because of the stimulant medication I was put on (first Vyvanse, then Adderall XR), the condition went unnoticed until after I had taken the medication.

Youtube video http://www.youtube.com/watch?v=RMaCE5RT54c This video was about the difference in ADD and ADHD. Not only were the differences between the two defined, but the beneficial qualities of ADHD were mentioned. Most people with ADHD are very caring and empathetic people, as well as very talented. They are also very intelligent!

references http://emedicine.medscape.com/article/289350-overview#a0104 http://www.psychologytoday.com/blog/dont-delay/201001/procrastination-and-adult-adhd http://www.bnl.gov/newsroom/news.php?a=1565 http://www.mayoclinic.com/health/adhd/DS00275/DSECTION=risk-factors Pharmacology for Nurses: A Pathophysiologic Approach 4th ed. Pg. 202-207