Disruptive Behavioral Disorders

Overview

Review the case study and respond to the following clinical judgment questions. Submit your answers on a Word document to Brightspace.

Tasks

Case Study:

Paxton, an 8-year-old client, arrives for an outpatient appointment for evaluation of “impulsiveness and aggression.” Paxton is accompanied by his father, who reports receiving calls from school almost daily regarding Paxton’s behavior. Other students do not want to include Paxton in group activities due to his behaviors. Paxton’s father reports having to leave work frequently to pick him up at school due to his disruptive behavior in class. Paxton’s father also reports that he has been less structured on
Paxton at home since separating from his mother. The father provides family medical history, which indicates the mother was treated for attention deficit-hyperactivity disorder (ADHD) as a child and the father has longstanding anxiety-related issues. The father states that if Paxton continues to have bad behaviors at school, he will be sent to an alternative school or suspended.

Questions:

1. Recognize Cues (Assessment)
   ● What assessment information is relevant to disruptive behavioral disorders?
2. Analysis Clues (Analysis)
   ● What risk factors linked to disruptive behavioral disorders are reported in Paxton?
   ● How are impulsive behaviors impacting both Paxton and his father?
3. Prioritize Hypotheses (Analysis)
   ● What is the priority problem for Paxton? Provide a rationale for your decision.
4. Generate Solutions (Planning)
   ● Identify a client outcome for the priority problem.
5. Take Actions (Implementation)
   ● Identify three nursing interventions based on the prioritized client problems.

Paxton returns to the outpatient clinic for a 1-month follow-up visit. His father reports working with him to maintain a daily routine and states that Paxton now adheres to the routine on most days independently, with reminders or verbal cues. The father also states he has talked with school staff about identifying triggers and providing Paxton with the opportunity to perform relaxation techniques when triggers are identified. The father reports calls from school regarding negative behaviors have decreased and Paxton has even made some friends in his class.

6. Evaluate Outcomes (Evaluation)

● What response by Paxton indicates that the nursing interventions were effective?
● What other nursing interventions might you implement if the client outcomes were not met?