The school nurse is called to the classroom to assist with a 7-year-old with attention-deficit hyperactivity disorder who is throwing books and hitting the other children. What is the best initial action for the nurse to take?

Question

Quizplus · Accepted Answer

A key feature of attention-deficit hyperactivity disorder (ADHD) is hyperactivity; however, some children with ADHD behave aggressively and have difficulty controlling anger, especially when frustrated or if unable to meet demands and challenges. An immediate intervention to help settle an out-of-control child is deep breathing. Taking slow, deep breaths relaxes the body, slows the heart rate, and distracts the child from inappropriate behaviors. Asking the child to blow up a balloon provides an easy mode of distraction and engages the child in a deep breathing exercise. After the child is calm, the nurse and the child can further discuss the disruptive behavior. Nursing interventions include the following: Stay calm and remove the child from the source of frustration/angerAssist the child in calming down with deep breathing exercisesDiscuss what precipitated the behavior and why the behavior is wrongDiscuss acceptable ways of expressing anger and frustrationAcknowledge that controlling anger is difficultProvide rewards for appropriate behaviorDiscuss the consequences of inappropriate behavior Stay calm and remove the child from the source of frustration/anger Assist the child in calming down with deep breathing exercises Discuss what precipitated the behavior and why the behavior is wrong Discuss acceptable ways of expressing anger and frustration Acknowledge that controlling anger is difficult Provide rewards for appropriate behavior Discuss the consequences of inappropriate behavior (Option A) Methylphenidate is not used on a PRN basis; it is administered daily in 2-3 divided doses (or in sustained release form) 30-45 minutes before meals. (Option C) Isolating the child is punitive and not therapeutic; instead, remove the child from the source of anger. (Option D) Reminding the child of the consequences of inappropriate behavior is a valid intervention. However, the best action is to help the child calm down and relax first. Educational objective: The priority intervention for a child with ADHD who is engaging in aggressive behavior is to assist the child in calming down and gaining control. Deep breathing exercises are an easy and efficient approach to help the body and mind slow down and relax.

The School Nurse Is Called to the Classroom to Assist