NURSING PROBLEMS FOR A CLIENT WITH ADHD

 Risk for injury

 Risk for self-directed or other directed violence
 Defensive coping
 Impaired social interaction
 Ineffective coping
 Noncompliance
 Anxiety (moderate to severe)
 Compromised family coping
 Imbalanced nutrition: Less than body requirements
 Ineffective family therapeutic regimen management
 Interrupted family processes
 Risk for impaired parenting
 Forgetfulness
 Deficient knowledge

NURSING DIAGNOSIS-1
Risk for injury related to inability to perceive potentially harmful
situations, intrusive behaviour with others and impulsivity.

GOAL

 By the end of 24 hours, the client will be free from injury or

unnecessary risks and respond to limits regarding intrusion on
others

IMPLEMENTATION
NURSING RATIONALE EVELUATION
INTERVENTIONS Assess for the client’s
Create a therapeutic To create mutual trust safety
nurse client between the
relationship nurse and the client

Do not assume that To properly manage

the client knows the client because
proper or expected developmentally, the
behavior client maybe be
unable to process
social cues to guide
reasonable behaviour
choices
Help client channel Physical activities can
energy constructively; provide an outlet for
participation in the client’s excess
activities using gross energy, relaxation can
motor activities is best facilitate sleep.
like exercising and
cleaning

Remove obvious Remove/lessen

harmful objects (e.g. Factors for injuries
sharp objects, etc.)

Talk with the client This provides the

about safe and unsafe client with clear
behaviour and that expectations
unsafe behaviour will
have bad
consequences
Provide supervision The client’s ability to
for potentially perceive harmful
dangerous situations consequences of a
and limit the client’s behavior is impaired
participation in
activities when safety
cannot be ensured

Make corrective Specific feedback will

feedback as specific help the client
as possible, for understand
example,’’ do not expectations.
jump down the stairs.
Walk down one step
at a time”
Provide consequences The client will be
that are directly better able to draw the
related to the correlation between
undesirable undesirable behavior
behaviour. Institute and consequences if
consequences as soon the two are related to
as possible after the each other ( negative
occurrence of the reinforcement)
behavior.

NURSING DIAGNOSIS-2
Impaired social interaction related to insufficient or excessive quantity
or ineffective quality of social exchange as evidenced by patient
isolating himself or friends hating him.

GOAL
  By the end of 14 days, the client will start interacting well with the
nurse, friends, school staff or family members and complete tasks
or assignments with assistance
IMPLEMENTATION
NURSING RATIONALE EVALUATION
INTERVENTION
Develop a trusting To develop mutual Assess the client’s
therapeutic trust between the social skills while
relationship with the nurse and the client interacting with the
client and convey Unconditional nurse, friends , family
acceptance of the acceptance increases members
child separate from feelings of self-wealth
unacceptable behavior
Identify factors that The external stimuli
aggravate and that exacerbate the
alleviate the client’s client’s problems can
performance be identified and
minimized. Likewise
any that positively
influence the client
can be effectively
used.
Provide an The client’s ability to
environment as free deal with external
from distractions as stimulation is
possible. impaired.
Engage the client’s
attention before
giving instructions (l.e
call the client’s name
and establish
Eye contact.) The client must hear
instructions as a first
step toward
compliance

Give instructions The client’s ability to

slowly, using simple comprehend
language and concrete instructions
directions (especially if they are
complex or abstract)
is impaired
Allow breaks during The client’s restless
which the client can energy can be given
move around an acceptable outlet,
so he or she can
attend to future tasks
more effectively.
Ask the client to Repetition
repeat instructions demonstrates that the
before beginning tasks client has accurately
received the
information
Separate complex The likelihood of
tasks into small steps success is enhanced
with less complicated
components of a task
Initially, assist the If the client is unable
client to complete to complete a task
tasks then progress to independently, having
prompting or assistance will allow
reminding the client success and then
to perform tasks or amount of
assignments intervention gradually
 is decreased to
increase client’s
independence as the
client’s abilities
increase
Engage the client in To help him interact
group therapy with friends,
understand himself
and develop social
skills
Give the client This approach called
positive feedback for shaping, is a
performing behaviors behavioral procedure
that come close to in which successive
task achievement approximations of a
desired behavior are
positively reinforced.
It allows rewards to
occur as the client
gradually masters the
actual expectation.

NURSING DIAGNOSIS-3

 Imbalanced nutrition: Less than body requirements related to over

activity as evidenced by muscle wasting or weight loss

GOAL

Immediate

By the end of 7 days of nursing interventions, the client will

increase caloric and nutritional intake
Stabilization

Client will develop an adequate nutritional status and maintain a

healthy weight level by the end of two months.

IMPLEMENTATION

NURSING RATIONALE EVALUATION

INTERVENTION
Provide small To restore energy Assess signs of
frequent energy the client loses malnutrition
giving foods
Provide a quiet The client may be
environment with easily distracted by
decreased stimulation external stimuli
for meal times and
assist the client with
eating as necessary
Encourage oral fluids To provide adequate
intake, water and hydration
juices
Avoid discussing Relaxation around
emotional issues meal times promotes
before, during and digestion.
immediately after
meals The client may have
used not eating as a
way of dealing with
anxiety

Encourage oral To boost up appetite

hygiene
Provide one to one To ensure that the
 supervision of the client eats the food
client during meal-
times and after meals
Weigh the client The client’s weight
daily gain or loss is a
measure of health
Administer diazepam Diazepam binds to
5mg PO prn as GABA receptors in
prescribed. the brain and calms
the patient.

NURSING DIAGNOSIS-4

Deficient knowledge related Poor ability to learn and retain new skills

and perform previously learned skills secondary to inattention and over
activity evidenced by poor performance in class.

GOAL
By the end of 14 days of nursing intervention the client will be able
 To able to establish methods to help in remembering essential
things when possible
 Perform necessary procedures correctly and explain reasons for
the actions

IMPLEMENTATION
NURSING RATIONALE EVALUATI
INTERVENTION ON
State objectives clearly To meet learners needs Assess
in learner’s terms client’s
performance
in class
Provide positive reinforce Encourages continuation of 
ment effort

Provide an environment To facilitate learning

conducive for learning effectively

Provide active role for Promote self-control

client in learning process over situation

Begin with the information Limits sense of

that the client’s already overwhelmed
knows and move to what
the client does not know,
progressing rom simple to
complex

Implement appropriate To increase level of

memory retraining retention
techniques, such as
keeping calendar, writing
list, memory cue games,
mnemonic device using
computers, and so forth

Provide for / emphasize To avoid fatigue

importance of pacing
learning activities and
having appropriate rest