Subjective.<\/u><\/strong><\/h3>\n\n\n\nChief complaint<\/strong>:The client\u2019s grandmother reports \u201cdeteriorating behavior.\u201d<\/p>\n\n\n\nSource of reliability: <\/strong>Reliability of information is good. Presents with grandmother.<\/p>\n\n\n\nPresent illness<\/strong>: <\/em>The patient has a history of neglect and parental abuse<\/a>. He has been under the care of his grandmother. Recently, his behavior has deteriorated since her sister was placed in the same care as him. He envies attention given to her sister. He becomes easily angered, moods shift from constricted to volatile, with frequent angry outbursts that carry over to and interfere with school. The client shows multiple signs of arousal, including insomnia, impaired concentration, edginess, and irritability.(Oppositional Defiant Disorder and ADHD Case Study Comprehensive Nursing Essay Example)<\/p>\n\n\n\n![\"Oppositional](\"https:\/\/nursingstudy.org\/examples\/wp-content\/uploads\/2023\/11\/Blog-What-Is-An-LPN-1030x528.jpg\")
<\/figure>\n\n\n\nCurrent psych meds: <\/strong>None.<\/p>\n\n\n\nPast psychiatric history: <\/strong>No previous hospitalization and medication reported. Diagnosed with oppositional defiant disorder and ADHD<\/p>\n\n\n\nPast medical history: <\/strong>Allergies: None<\/p>\n\n\n\nSubstance use\/abuse: <\/strong>None.<\/p>\n\n\n\nPast family, social history:<\/strong><\/p>\n\n\n\nFamily psych hx:<\/em> The mother had a history of stress from her abusive husband, now separated. The client\u2019s parents had a history of drug and alcohol abuse.(Oppositional Defiant Disorder and ADHD Case Study Comprehensive Nursing Essay Example)<\/p>\n\n\n\nEducation\/Employment\/Disability: <\/em>The client is in Middle school, 6th<\/sup> grade. Classes include remedial reading, Math, 6th grade Science, Art, Social Studies, and PE. \u00a0He is at least two years behind in reading. No Individualized Education Program. The client is talkative and social with his peers when in a good mood.(Oppositional Defiant Disorder and ADHD Case Study Comprehensive Nursing Essay Example)<\/p>\n\n\n\nPrimary support system: <\/em>Suffered neglect, physical abuse<\/a>, and parental substance abuse. The client has been in the care of his grandmother since he was18 months old.(Oppositional Defiant Disorder and ADHD Case Study Comprehensive Nursing Essay Example)<\/p>\n\n\n\nHobbies: <\/em>LikesArt and the Remedial Reading.<\/p>\n\n\n\nReview of systems-pertinent (per GM):<\/strong><\/p>\n\n\n\nConstitutional:<\/strong> denies: fatigue, no fever or chills<\/p>\n\n\n\nCardiovascular: <\/strong>denies: chest pain, palpitations<\/p>\n\n\n\nPulmonary:<\/strong> denies: shortness of breath, wheezing, or cough<\/p>\n\n\n\nGI<\/strong>: denies: n\/v\/c\/d, states appetite is good, and eats three meals a day<\/p>\n\n\n\nGU: <\/strong>Not sexually active<\/p>\n\n\n\nNeuro: <\/strong>denies: n\/v\/c\/d, report good appetite, and eats three meals a day<\/p>\n\n\n\nMusculoskeletal:<\/strong> denies: muscle tension or joint pains<\/p>\n\n\n\nSkin:<\/strong> denies: rash, hives, itching(Oppositional Defiant Disorder and ADHD Case Study Comprehensive Nursing Essay Example)<\/p>\n\n\n\nObjective.<\/u><\/strong><\/h3>\n\n\n\nVitals: BP: 130\/77 P: 94 Ht: 57.5in Wt: 89 BMI: 18.9<\/strong><\/p>\n\n\n\nAppearance: <\/strong>Well kempt and appropriately dressed. Makes good eye contact.<\/p>\n\n\n\nAttitude\/interaction: <\/strong>Calm and interactive. Appears restricted<\/p>\n\n\n\nActivity level\/behavior<\/strong>: In no acute distress. No psychomotor retardation or agitation.<\/p>\n\n\n\nOrientation: <\/strong>Alert and oriented in all spheres.<\/p>\n\n\n\nSpeech: <\/strong>clear and fluent, sounds mildly anxious<\/p>\n\n\n\nThought content\/process\/perception: <\/strong>Thought is past-oriented and somber.<\/p>\n\n\n\nMood\/affect: <\/strong>Mood is reported as \u201cimpulsive,\u201d affect appropriate for the situation.<\/p>\n\n\n\nJudgment\/insight\/cognitive\/memory: <\/strong>Poor judgment and insight due to impulsivity. Cognition is below average. Difficulty with abstract. Apparent cognitive deficits.(Oppositional Defiant Disorder and ADHD Case Study Comprehensive Nursing Essay Example)<\/p>\n\n\n\nAttention: <\/strong>Noted some attention and concentration problems during the exam<\/p>\n\n\n\nTesting: <\/strong>No test done. UDS negative.<\/p>\n\n\n\nAssessment.<\/u><\/strong> <\/strong><\/em><\/h3>\n\n\n\n(F90.9) Attention-Deficit \/Hyperactivity Disorder.<\/u><\/strong><\/p>\n\n\n\n(F91.3) <\/u><\/strong>Oppositional Defiant Disorder.<\/u><\/strong><\/p>\n\n\n\n(F34.8) Disruptive mood dysregulation disorder.<\/u><\/strong><\/p>\n\n\n\n(F43.10) <\/u><\/strong>Posttraumatic Stress Disorder<\/u><\/strong><\/p>\n\n\n\n(F94.1) Reactive Attachment Disorder<\/u><\/strong><\/p>\n\n\n\nPlan: Medication treatment prescribed & education provided: <\/strong>(Discuss treatment & patient<\/em><\/p>\n\n\n\neducation, discuss follow up plan for the patient)<\/em><\/p>\n\n\n\nThe plan will be to start the client on Methylphenidate\u00a0<\/a>5mg twice per day. Methylphenidate\u00a0is a CNS stimulant and contributes to hyperactivity and impulse control in children and adolescents with ADHD (Huss et al., 2017). Refer the client to a behavioral therapist for behavior management to improve a child\u2019s self-esteem, control, and behavior (CDC, 2020). The caregiver should also be trained in behavior therapy to gain skills and strategies to help the client succeed in his relationships. Recommend an IEP to ensure the client thrives in school and achieves his potential by changing how and what they learn (Spiel, Evans & Langberg, 2014). Educate the grandmother of the medication\u2019s side effects such as irritability, nervousness, diarrhea, and vomiting. The client and grandmother voice understanding and agrees with the treatment plan.(Oppositional Defiant Disorder and ADHD Case Study Comprehensive Nursing Essay Example)<\/p>\n\n\n\nRequired laboratory monitoring with frequency: <\/strong>None required<\/p>\n\n\n\nThe non-pharmacologic treatment recommended: <\/strong>Behavioral therapy.<\/p>\n\n\n\nDuration until next scheduled visit: <\/strong>2 weeks(Oppositional Defiant Disorder and ADHD Case Study Comprehensive Nursing Essay Example)<\/p>\n\n\n\nBilling code: 25468, Office visit, established<\/strong><\/p>\n\n\n\n![\"Oppositional](\"https:\/\/nursingstudy.org\/examples\/wp-content\/uploads\/2023\/11\/Servant-Leadership.jpg\")
<\/figure>\n\n\n\nReferences<\/strong><\/h2>\n\n\n\nCentre for Disease Control and Prevention. (September 2020). Parent Training in Behavior Management for ADHD. Retrieved 9 September 2021,(Oppositional Defiant Disorder and ADHD Case Study Comprehensive Nursing Essay Example) from https:\/\/www.cdc.gov\/ncbddd\/adhd\/behavior-therapy.html<\/p>\n\n\n\n
Huss, M., Duhan, P., Gandhi, P., Chen, C. W., Spannhuth, C., & Kumar, V. (2017). Methylphenidate dose optimization for ADHD treatment: a review of safety, efficacy, and clinical necessity.\u00a0Neuropsychiatric disease and treatment<\/em>. (Oppositional Defiant Disorder and ADHD Case Study Comprehensive Nursing Essay Example)https:\/\/dx.doi.org\/10.2147%2FNDT.S130444<\/a><\/p>\n\n\n\nSpiel, C. F., Evans, S. W., & Langberg, J. M. (2014). Evaluating the content of Individualized Education Programs and 504 Plans of young adolescents with attention-deficit\/hyperactivity disorder.\u00a0School Psychology Quarterly<\/em>,\u00a029<\/em>(4), 452. (Oppositional Defiant Disorder and ADHD Case Study Comprehensive Nursing Essay Example)https:\/\/dx.doi.org\/10.1037%2Fspq0000101<\/a><\/p>\n\n\n\n![\"Oppositional](\"https:\/\/nursingstudy.org\/examples\/wp-content\/uploads\/2023\/09\/image-8.png\")
<\/figure>\n","protected":false},"excerpt":{"rendered":"Oppositional Defiant Disorder and ADHD Case Study Comprehensive Nursing Essay Example Client ID: 12-year-old boy Subjective. Chief complaint:The client\u2019s grandmother reports \u201cdeteriorating behavior.\u201d Source of reliability: Reliability of information is…<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":"","_wpscppro_dont_share_socialmedia":false,"_wpscppro_custom_social_share_image":0,"_facebook_share_type":"","_twitter_share_type":"","_linkedin_share_type":"","_pinterest_share_type":"","_linkedin_share_type_page":"","_instagram_share_type":"","_medium_share_type":"","_threads_share_type":"","_google_business_share_type":"","_selected_social_profile":[],"_wpsp_enable_custom_social_template":false,"_wpsp_social_scheduling":{"enabled":false,"datetime":null,"platforms":[],"status":"template_only","dateOption":"today","timeOption":"now","customDays":"","customHours":"","customDate":"","customTime":"","schedulingType":"absolute"},"_wpsp_active_default_template":true},"categories":[1061],"tags":[1153],"class_list":["post-262947","post","type-post","status-publish","format-standard","hentry","category-nursing-essays","tag-essay-discussion"],"_links":{"self":[{"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/posts\/262947","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/users\/16"}],"replies":[{"embeddable":true,"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/comments?post=262947"}],"version-history":[{"count":1,"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/posts\/262947\/revisions"}],"predecessor-version":[{"id":271228,"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/posts\/262947\/revisions\/271228"}],"wp:attachment":[{"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/media?parent=262947"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/categories?post=262947"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/tags?post=262947"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
Source of reliability: <\/strong>Reliability of information is good. Presents with grandmother.<\/p>\n\n\n\n Present illness<\/strong>: <\/em>The patient has a history of neglect and parental abuse<\/a>. He has been under the care of his grandmother. Recently, his behavior has deteriorated since her sister was placed in the same care as him. He envies attention given to her sister. He becomes easily angered, moods shift from constricted to volatile, with frequent angry outbursts that carry over to and interfere with school. The client shows multiple signs of arousal, including insomnia, impaired concentration, edginess, and irritability.(Oppositional Defiant Disorder and ADHD Case Study Comprehensive Nursing Essay Example)<\/p>\n\n\n\n Current psych meds: <\/strong>None.<\/p>\n\n\n\n Past psychiatric history: <\/strong>No previous hospitalization and medication reported. Diagnosed with oppositional defiant disorder and ADHD<\/p>\n\n\n\n Past medical history: <\/strong>Allergies: None<\/p>\n\n\n\n Substance use\/abuse: <\/strong>None.<\/p>\n\n\n\n Past family, social history:<\/strong><\/p>\n\n\n\n Family psych hx:<\/em> The mother had a history of stress from her abusive husband, now separated. The client\u2019s parents had a history of drug and alcohol abuse.(Oppositional Defiant Disorder and ADHD Case Study Comprehensive Nursing Essay Example)<\/p>\n\n\n\n Education\/Employment\/Disability: <\/em>The client is in Middle school, 6th<\/sup> grade. Classes include remedial reading, Math, 6th grade Science, Art, Social Studies, and PE. \u00a0He is at least two years behind in reading. No Individualized Education Program. The client is talkative and social with his peers when in a good mood.(Oppositional Defiant Disorder and ADHD Case Study Comprehensive Nursing Essay Example)<\/p>\n\n\n\n Primary support system: <\/em>Suffered neglect, physical abuse<\/a>, and parental substance abuse. The client has been in the care of his grandmother since he was18 months old.(Oppositional Defiant Disorder and ADHD Case Study Comprehensive Nursing Essay Example)<\/p>\n\n\n\n Hobbies: <\/em>LikesArt and the Remedial Reading.<\/p>\n\n\n\n Review of systems-pertinent (per GM):<\/strong><\/p>\n\n\n\n Constitutional:<\/strong> denies: fatigue, no fever or chills<\/p>\n\n\n\n Cardiovascular: <\/strong>denies: chest pain, palpitations<\/p>\n\n\n\n Pulmonary:<\/strong> denies: shortness of breath, wheezing, or cough<\/p>\n\n\n\n GI<\/strong>: denies: n\/v\/c\/d, states appetite is good, and eats three meals a day<\/p>\n\n\n\n GU: <\/strong>Not sexually active<\/p>\n\n\n\n Neuro: <\/strong>denies: n\/v\/c\/d, report good appetite, and eats three meals a day<\/p>\n\n\n\n Musculoskeletal:<\/strong> denies: muscle tension or joint pains<\/p>\n\n\n\n Skin:<\/strong> denies: rash, hives, itching(Oppositional Defiant Disorder and ADHD Case Study Comprehensive Nursing Essay Example)<\/p>\n\n\n\n Vitals: BP: 130\/77 P: 94 Ht: 57.5in Wt: 89 BMI: 18.9<\/strong><\/p>\n\n\n\n Appearance: <\/strong>Well kempt and appropriately dressed. Makes good eye contact.<\/p>\n\n\n\n Attitude\/interaction: <\/strong>Calm and interactive. Appears restricted<\/p>\n\n\n\n Activity level\/behavior<\/strong>: In no acute distress. No psychomotor retardation or agitation.<\/p>\n\n\n\n Orientation: <\/strong>Alert and oriented in all spheres.<\/p>\n\n\n\n Speech: <\/strong>clear and fluent, sounds mildly anxious<\/p>\n\n\n\n Thought content\/process\/perception: <\/strong>Thought is past-oriented and somber.<\/p>\n\n\n\n Mood\/affect: <\/strong>Mood is reported as \u201cimpulsive,\u201d affect appropriate for the situation.<\/p>\n\n\n\n Judgment\/insight\/cognitive\/memory: <\/strong>Poor judgment and insight due to impulsivity. Cognition is below average. Difficulty with abstract. Apparent cognitive deficits.(Oppositional Defiant Disorder and ADHD Case Study Comprehensive Nursing Essay Example)<\/p>\n\n\n\n Attention: <\/strong>Noted some attention and concentration problems during the exam<\/p>\n\n\n\n Testing: <\/strong>No test done. UDS negative.<\/p>\n\n\n\n (F90.9) Attention-Deficit \/Hyperactivity Disorder.<\/u><\/strong><\/p>\n\n\n\n (F91.3) <\/u><\/strong>Oppositional Defiant Disorder.<\/u><\/strong><\/p>\n\n\n\n (F34.8) Disruptive mood dysregulation disorder.<\/u><\/strong><\/p>\n\n\n\n (F43.10) <\/u><\/strong>Posttraumatic Stress Disorder<\/u><\/strong><\/p>\n\n\n\n (F94.1) Reactive Attachment Disorder<\/u><\/strong><\/p>\n\n\n\n Plan: Medication treatment prescribed & education provided: <\/strong>(Discuss treatment & patient<\/em><\/p>\n\n\n\n education, discuss follow up plan for the patient)<\/em><\/p>\n\n\n\n The plan will be to start the client on Methylphenidate\u00a0<\/a>5mg twice per day. Methylphenidate\u00a0is a CNS stimulant and contributes to hyperactivity and impulse control in children and adolescents with ADHD (Huss et al., 2017). Refer the client to a behavioral therapist for behavior management to improve a child\u2019s self-esteem, control, and behavior (CDC, 2020). The caregiver should also be trained in behavior therapy to gain skills and strategies to help the client succeed in his relationships. Recommend an IEP to ensure the client thrives in school and achieves his potential by changing how and what they learn (Spiel, Evans & Langberg, 2014). Educate the grandmother of the medication\u2019s side effects such as irritability, nervousness, diarrhea, and vomiting. The client and grandmother voice understanding and agrees with the treatment plan.(Oppositional Defiant Disorder and ADHD Case Study Comprehensive Nursing Essay Example)<\/p>\n\n\n\n Required laboratory monitoring with frequency: <\/strong>None required<\/p>\n\n\n\n The non-pharmacologic treatment recommended: <\/strong>Behavioral therapy.<\/p>\n\n\n\n Duration until next scheduled visit: <\/strong>2 weeks(Oppositional Defiant Disorder and ADHD Case Study Comprehensive Nursing Essay Example)<\/p>\n\n\n\n Billing code: 25468, Office visit, established<\/strong><\/p>\n\n\n\n Centre for Disease Control and Prevention. (September 2020). Parent Training in Behavior Management for ADHD. Retrieved 9 September 2021,(Oppositional Defiant Disorder and ADHD Case Study Comprehensive Nursing Essay Example) from https:\/\/www.cdc.gov\/ncbddd\/adhd\/behavior-therapy.html<\/p>\n\n\n\n Huss, M., Duhan, P., Gandhi, P., Chen, C. W., Spannhuth, C., & Kumar, V. (2017). Methylphenidate dose optimization for ADHD treatment: a review of safety, efficacy, and clinical necessity.\u00a0Neuropsychiatric disease and treatment<\/em>. (Oppositional Defiant Disorder and ADHD Case Study Comprehensive Nursing Essay Example)https:\/\/dx.doi.org\/10.2147%2FNDT.S130444<\/a><\/p>\n\n\n\n Spiel, C. F., Evans, S. W., & Langberg, J. M. (2014). Evaluating the content of Individualized Education Programs and 504 Plans of young adolescents with attention-deficit\/hyperactivity disorder.\u00a0School Psychology Quarterly<\/em>,\u00a029<\/em>(4), 452. (Oppositional Defiant Disorder and ADHD Case Study Comprehensive Nursing Essay Example)https:\/\/dx.doi.org\/10.1037%2Fspq0000101<\/a><\/p>\n\n\n\n Oppositional Defiant Disorder and ADHD Case Study Comprehensive Nursing Essay Example Client ID: 12-year-old boy Subjective. Chief complaint:The client\u2019s grandmother reports \u201cdeteriorating behavior.\u201d Source of reliability: Reliability of information is…<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":"","_wpscppro_dont_share_socialmedia":false,"_wpscppro_custom_social_share_image":0,"_facebook_share_type":"","_twitter_share_type":"","_linkedin_share_type":"","_pinterest_share_type":"","_linkedin_share_type_page":"","_instagram_share_type":"","_medium_share_type":"","_threads_share_type":"","_google_business_share_type":"","_selected_social_profile":[],"_wpsp_enable_custom_social_template":false,"_wpsp_social_scheduling":{"enabled":false,"datetime":null,"platforms":[],"status":"template_only","dateOption":"today","timeOption":"now","customDays":"","customHours":"","customDate":"","customTime":"","schedulingType":"absolute"},"_wpsp_active_default_template":true},"categories":[1061],"tags":[1153],"class_list":["post-262947","post","type-post","status-publish","format-standard","hentry","category-nursing-essays","tag-essay-discussion"],"_links":{"self":[{"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/posts\/262947","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/users\/16"}],"replies":[{"embeddable":true,"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/comments?post=262947"}],"version-history":[{"count":1,"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/posts\/262947\/revisions"}],"predecessor-version":[{"id":271228,"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/posts\/262947\/revisions\/271228"}],"wp:attachment":[{"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/media?parent=262947"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/categories?post=262947"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/tags?post=262947"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}<\/figure>\n\n\n\nObjective.<\/u><\/strong><\/h3>\n\n\n\n
Assessment.<\/u><\/strong> <\/strong><\/em><\/h3>\n\n\n\n
<\/figure>\n\n\n\nReferences<\/strong><\/h2>\n\n\n\n
<\/figure>\n","protected":false},"excerpt":{"rendered":"