PATHOPHYSIOLOGY

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. It results from
genetic, neurobiological, and environmental factors that affect brain structure and function, leading to executive dysfunction, emotional dysregulation, and motor restlessness.

Precipitating Factors:
Predisposing Factors: Increased
• Glutamate
Early use of media with excessive
Age: 4 years old
Prefrontal Cortex -
screen time exposure
Gender: Female Basal Ganglia
• Irregular sleep patterns or sleep
Family History • High levels of noise or chaotic
surroundings
Prenatal exposure to tobacco: Second-hand
smoker • Social rejection or difficulty interacting with
peers

Delayed prefrontal cortex maturation Neurotransmitter Imbalance Disrupted Neural Pathways

Reduced basal ganglia volume Affects motivation, Weak Prefrontal Cortex Basal Ganglia
↓ Dopamine
-Prefrontalattention,
Cortex impulse control Connection
Smaller cerebellum -Prefrontal Cortexfocus, working
Impairs
↓ Norepinephrine Weak connection affects
memory, cognitive flexibility self-regulation
Weak connections in executive function circuits focus, working memory,
Weak connection affects self-regulation ↑ Glutamate Causes hyperactivity,
cognitive flexibility Impairs Limbic System Heightened emotional
overstimulation
focus, working memory, Overactivity responses, poor stress
Serotonin cognitive flexibility management
Dysregulation leads to emotional
dysregulation
Default Mode Increased distractibility,
Network (DMN) excessive daydreaming
Dysfunction

Reduced alertness,
Reticular poor sustained
Activating System attention excessive
(RAS) Impairment daydreaming
 Central Nervous System Cardiovascular System Musculoskeletal System

Impaired Overactive sympathetic Delayed motor coordination

executive function nervous system

Excessive fidgeting, difficulty

Poor impulse regulation, Sensitivity to stress with fine motor tasks
high distractibility triggers

Poor handwriting, difficulty

gripping objects
Hyperactivity and restlessness

Manifestations

Behavioral Symptoms
Long-Term Complications

Easily distracted, trouble following multi-step

Inattention
instructions, forgetfulness
Academic Struggles Low comprehension

Hyperactivity Constant movement, running excessively, fidgeting

Social Challenges
Impulsivity Interrupting, acting without thinking, blurting out answers

Increased risk of injuries Impulsivity leads to frequent

Emotional
Frequent tantrums, mood swings, frustrations accidents
Dysregulation

Sleep Problems Difficulty falling asleep, restless sleep,

waking up frequently
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Factors Nursing Responsibilities

Disease Process

Affected Systems
• Assist in implementing structured routines (e.g., providing visual
schedules, breaking tasks into smaller steps).
Behavioral Symptoms • Support positive reinforcement by encouraging good behavior and
documenting progress.
Long Term Complications • Educate on behavioral management techniques (e.g., consistency in
discipline, reward systems).
Nursing Responsibilities • Offer emotional support to the child, acknowledging their feelings and
frustrations.
• Help the child develop coping skills (e.g., mindfulness techniques or
stress-relieving activities).
• Build rapport to encourage the child to express their emotions and
challenges.