Question

An adolescent diagnosed with attention-deficit/hyperactivity disorder (ADHD) is having difficulty maintaining concentration in the inpatient milieu. Which nursing intervention would help improve the client's task performance?

1) Mandate that the client remain in her room until all homework is complete.
2) Remove privileges if homework is not completed within a 2-hour period.
3) Encourage dividing tasks into smaller, attainable steps and reward successful completion.
4) Seek a physician's order to discontinue the stimulant methylphenidate (Ritalin).

Answer 1

The best nursing intervention for an ADHD patient struggling to maintain concentration is to encourage breaking down tasks into smaller steps and rewarding completion, rather than punitive measures or medication cessation.

Step-by-step explanation:

To improve task performance for an adolescent with attention-deficit/hyperactivity disorder (ADHD), the most supportive nursing intervention would be to encourage dividing tasks into smaller, attainable steps and reward successful completion. This approach helps individuals with ADHD manage their executive functioning difficulties by breaking down overwhelming tasks into more manageable parts, thereby reducing the potential for frustration and distraction. Offering rewards for each completed step can also provide additional motivation and reinforce positive behavior.

Mandating that the patient remains in their room until all homework is complete or removing privileges can exacerbate feelings of frustration or failure, potentially leading to increased stress and decreased motivation, which are counterproductive for those with ADHD. Discontinuing a stimulant like methylphenidate (Ritalin), without proper medical assessment, is not advisable as these medications can increase focus and decrease impulsivity in patients with ADHD.