How to write nursing essays on Soap Notes on ADHD And ODD

Introduction

Attention-deficit / hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) are behavior disorders manifested by defiance and aggression (Centre for disease control, 2022). It is common in children but can be diagnosed in adolescents. Children with ADHD are more likely to be diagnosed with ODD (Centre for disease control, 2022). This paper will focus on the SOAP notes for a patient with ADHD and ODD.

Subjective Data

During an interview with Child Protective Services (CPS), Joshua’s mother admitted she had tremendous stress due to frequent violence with her husband. She acknowledged bringing up Joshua was tough because he was always irritable and rejected her attempts to console him. She reported that Joshua was restless and clingy most of the time, especially in his father’s presence, which she referred to as “slow to develop” (Case Vignette, 2022). She also admitted having a history of drug and alcohol abuse.

At the age of 5, an attempt to reunify Joshua with his parents failed. There were complaints from kindergarten on the physical state of Joshua (bruises on legs and arms), forcing his grandmother to take total care of him (Case Vignette, 2022). His parents separated, and he only got a chance to see his mother at family events and holidays. There was no history of contact with his father since the second set of allegations when he was five years old.

Joshua’s grandmother has a history of childhood trauma. She reports Joshua’s emotional outbursts make her more depressed and overwhelmed (Case Vignette, 2022). Additionally, she finds it challenging to provide consistent care to either of her children; this includes a reluctance to contact the school for her children’s progress.

 

Objective data

Joshua is 12 years boy attending Middle School as a 6^th grader. He has been under his grandmother’s custody since he was 18 months old (Case Vignette, 2022). He was removed from his parents by Child Protective Services (CPS) based on negligence, physical abuse and parental physical abuse. His behavior has declined since he was placed with his middle sibling at home. Also, he was strongly reactive to signs that his sister was receiving more attention than him. He is easily angered; the moods shift from constricted to volatile, with frequent angry bursts that carry over to and interfere with school. Additionally, he shows multiple signs of arousal, i.e., difficulty sleeping, impaired concentration, edginess and irritability (Case Vignette, 2022). Joshua was recently diagnosed with oppositional defiant disorder and ADHD, although he doesn’t have an IEP.

In school, he is currently taking the following classes: Remedial Reading, Math, 6^th grade Science, Art, Social studies and P.E. His favorite class is Art, and the least is remedial reading (Case Vignette, 2022). He is at least two years behind in reading; he is talkative and social with his peers when in a happy mood.

Assessment

Joshua’s mother reported Joshua had a history of irritation and rejecting consolation from her. Mostly, he was restless and clingy in the presence of his father (Case Vignette, 2022). His behavior has been declining since her middle sister was placed with him at home and was strongly reactive to signs that she was receiving more attention than him. He is easily angered; the moods shift from constricted to volatile, with frequent angry bursts that carry over to and interfere with school.

Joshua has shown multiple signs of arousal: difficulty in sleeping, impaired concentration, edginess, and irritability (Case Vignette, 2022). He was recently diagnosed with ODD and ADHD, although he doesn’t have IEP. It was reported that he is two years behind in reading, his favorite class is Art, and his least favorite is remedial reading (Case Vignette, 2022). His parents have a history of alcohol and drug abuse, while the grandmother had childhood trauma.

Plan

There is no one treatment module for ODD and ADHD; it requires a multi-intervention plan to cater to the patient’s needs and close associates (Legg, 2022). For this case, it will consist of a combination of:

• Parents-management training programs and family therapy; to educate parents and family members on how to manage a child’s behavior (Legg, 2022). It includes appropriate techniques for positive reinforcement and discipline.
• Cognitive problem-solving skills training to reduce inappropriate responses to stressful situations and adopt accepted techniques in search circumstances (Legg, 2022).
• Social skills programs and school-based programs to educate the patient on how to relate positively with their peers (Legg, 2022). This should be carried out in a natural setting, for example, playing grounds and at school.
• Medication to help control symptoms of both ODD and ADHD, Start methylphenidate (Focalin) 2.5 mg twice a day (Rodden, 2022).
• A healthy balanced diet with omega-3 vitamin supplements.
• Health promotion; parents, should join support groups of patients with the same condition to avoid isolation (Rodden, 2022). Also, they should be familiar with the medication side effects.

References

Case Vignette. (2022). Doe.k12.de.us. Retrieved 14 January 2022, from https://www.doe.k12.de.us/cms/lib/DE01922744/Centricity/Domain/472/Case%20Vignette%20Joshua.pdf.

Centre for disease control. (2022). Other Concerns and Conditions with ADHD | CDC. Centers for Disease Control and Prevention. Retrieved 14 January 2022, from https://www.cdc.gov/ncbddd/adhd/conditions.html.

Legg, T. (2022). ADHD and ODD: What Does It Mean If Your Child Has Both Disorders?. Healthline. Retrieved 14 January 2022, from https://www.healthline.com/health/adhd/adhd-and-odd#:~:text=Some%20children%2C%20however%2C%20have%20a,may%20have%20difficulty%20sitting%20still.

Rodden, J. (2022). Oppositional Defiant Disorder Treatment. ADDitude. Retrieved 14 January 2022, from https://www.additudemag.com/oppositional-defiant-disorder-odd-treatment/.

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