The nurse is planning care for an 11-year-old admitted for surgical treatment of a fractured femur. The child also has attention-deficit hyperactivity disorder, predominantly inattentive type. What is the priority nursing action?

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Children with attention-deficit hyperactivity disorder (ADHD), predominantly inattentive type, have trouble holding attention on tasks or play activities, experience difficulty organizing tasks and activities, and are easily distracted/side-tracked. They cannot give close attention to detail and dislike and/or avoid tasks that require mental effort over a long period. The key nursing intervention to help the child with ADHD adjust to hospitalization is providing a calm, structured, organized, and consistent environment. A written chart or list of daily activities will help remind the child of what to expect and what will happen at any given time. A structured environment helps these children organize their thoughts and activities. (Option A) It is important for the child to keep up with school work to the fullest extent possible so the child does not fall behind. Catching up will be more difficult for a child with ADHD than for a child without the diagnosis. A structured environment can help the child plan time for school work. (Option C) It is important that children with ADHD have visitors as they will likely have impaired social skills and may feel socially isolated. However, the number of visitors may need to be limited to avoid an overly distracting environment. (Option D) Verbal explanations of what to expect during hospitalization can be provided in a clear, concise manner that allows the child to ask questions. However, because this child will be easily distracted, will not seem to listen when spoken to directly, and is often forgetful, verbal instructions may not be the most effective communication approach. Educational objective: The most important nursing intervention in caring for a child with ADHD is providing a structured, consistent, and organized environment. A written schedule of activities will remind the child what to expect at any given time.

The Nurse Is Planning Care for an 11-Year-Old Admitted for Surgical