NR 546 Week 7 Case Study- child and adolescent

The patient is a 6-year-old male accompanied by his mother and 7-year-old brother. Patient’s Chief Complaints: “My son is like the energizer bunny. When he plays, he is too rough with other kids.” History of Present Illness This boy was previously diagnosed with attention- deficit/hyperactivity disorder (ADHD). The school reports that he cannot stay seated, frequently calls out in class, is disorganized, cannot complete his assignments, and has been known to be disrespectful to adults. According to his mother, he is very impatient and impulsive. At age 3, the child was in the Head Start Program, and it was noted that he was demonstrating extreme hyperactivity, poor impulse control, and difficulty sustaining focus. Peer interactions were marked by aggression such as kicking and biting others. When told “no,” he would have extreme temper tantrums, where he would cry, scream, and destroy property. Such behaviors resulted in being permanently expelled from the program. At age 4, he was evaluated and diagnosed with ADHD, combined type. Medication was not prescribed at that time due to age. Physical Examination: Physical Examination (Obtained by Pediatrician 2 Days Earlier) Height: 3′8″, weight: 65 lb, BMI: 23.9 Vital signs: B/P, 100/60; P, 78; R, 16; T, 98.4 General: Well-nourished 6-year-old male HEENT: PERRLA, EOMI, vision is 20/20, and hearing acuity is unremarkable. Neck: No masses Pulmonary: No wheezing, rhonchi, or rales Cardiac: S1, S2 Abdomen: No distension, bowel sounds × 4 quadrants, no masses or hernias Lymph nodes: No swelling Extremities: 2+ pulses bilaterally Skin: No lesions or edema Neuro: CN II-XII intact