Naia Kassebeer

Nurse 360
2/27/16
Capstone: ADHD
The client is a14 year-old male diagnosed with ADHD and major depression. He
is currently living with his biological parents and two sisters. His father is in the Navy
and sole financial provider for the family. The client and family frequently move around
to accommodate the fathers occupation. His parents are of Mexican descent and are
devout members of the Catholic Church. The client is currently experiencing conflict
with his father, conflicts with his peers and is not performing well in school.
The client Suffers from ADHD and is currently taking Aderall 25 mg XR. The
disorder is marked by impulsivity, which can contribute to his past suicidal and homicidal
attempts. Medication compliance as well as non-pharmacologic therapies should be
involved in the plan of care to decrease impulsive symptoms. According to BMC Med
(2012) Non-pharmacological interventions such as specialized training for parents of
children with ADHD and cognitive behavioral therapy (CBT) for adults also reduce
symptoms, and a multimodal approach may have greater effect.
The patients inattentive symptoms may contribute to his inability to process
information rationally, which may cause anger and unfavorable reactions. Addressing the
underlying behavioral disorder through pharmacologic and non-pharmacologic methods
should be added into the plan of care as well. These interventions can be measurable by
evaluating the clients performance in school, and observing an increase in desirable
behaviors and a decrease in undesirable ones.
The client is lacking a stable social support system. The clients family will not
accept the clients sexual preference. The client does not truly believe in his familys

spiritual practices because it goes against his own beliefs so he has no spiritual preference
at this time. The clients frequent relocation has made it difficult to establish trust and
meaningful relationships with peers. According to Gulanick (2014, pg 54), ongoing
relationships establish trust, reduce feelings of isolation and may facilitate coping. The
Client who experiences suicidal and homicidal idealation suffers from ineffective coping,
which is an appropriate and relevant nursing priority for this patient.
Based on my treatment plan findings I would recommend that the client
participate in intensive family therapy. There are family counseling services for parents
of homosexual children and parents of children with ADHD. The parents need to
understand that unlike ADHD, and depression homosexuality is not a disease and cannot
be treated. The family must accept the client as a person and offer him support. With the
support of his family his anger may decrease and he may improve his coping abilities,
which will benefit his suicidal and homicidal idealations.
The client would also benefit from outpatient support groups. Adolescents have a
need for peer relationships. Support groups allow the client to meet peers who
understand the clients situation, and provide a positive support system as well. I wish
that this patient can find positive influences through these peers. Im hoping he can find
spirituality from an entity that accepts him as a whole. I hope once he begins to build
trust in peers and establish a strong support system, he wont have to move again and face
the stressors of relocation.

References
American Psychiatric Association: Diagnostic and Statistical Manual of Mental
Disorders, 5th ed. Arlington, VA., American Psychiatric Association, 2013.
Shaw, M., Hodgkins, P., Caci, H., Young, S., Kahle, J., Woods, A. G., & Arnold, E. (2012,
September 4). BMC Medicine. Retrieved February 25, 2016, from
http://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-10-99
https://www.understood.org/en/tools/through-your-childs-eyes/personalize