Chapter 57 ADHD / Narcolepsy Prep U
The pediatric client has been prescribed methylphenidate. Which statement should be included in the teaching plan for a client receiving methylphenidate?
"Adverse effects include hypertension and nervousness."
A nurse is instructing a mother about a new drug her son was prescribed for ADHD. The nurse should include which instructions?
Always take the drug in the morning 30 to 45 minutes before breakfast and lunch.
A child who is in first grade has been diagnosed with ADHD and has been initially prescribed atomoxetine 0.5 mg/kg PO. The child weighs 44 lb, so the nurse should prepare what dose?
10
A client calls the clinic reporting only being able to get a 1-month supply of pills for the client's son, who takes a CNS stimulant for ADHD. The nurse understands that these medications are given in limited numbers for what reason?
It reduces the likelihood of drug dependence or diversion.
A child was diagnosed with attention-deficit hyperactivity disorder and methylphenidate was prescribed for treatment to be taken once a day in a sustained release form. On future visits, what is a priority nursing assessment for this child?
weight and height
The community health nurse is conducting a class for parents of preschoolers. One of the parents asks if a child with ADHD will always have problems with hyperactivity. What is the nurse's best response?
"ADHD usually starts in childhood and may persist through adulthood."
A client's medication history includes a long-term prescription for modafinil. Which assessment question should the nurse ask the client to confirm why the medication was prescribed?
"Have you ever been diagnosed with narcolepsy?"
The parents of a child diagnosed with attention-deficit syndrome receive a prescription for a central nervous system (CNS) stimulant to treat their child. One of the parents states, "I don't understand why we're giving a stimulant to calm our child down." What is the nurse's bestresponse?
"It helps the reticular activating system, a part of the brain, to be more selective in response to incoming stimuli."
The nurse is teaching the parents of a child diagnosed with attention-deficit hyperactivity disorder how to administer extended release methylphenidate. What should the nurse teach the parents?
"It's best to give it at breakfast every day."
A female client asks why it is not legal to have a year's worth of prescription refills for Ritalin, since she has been on it for more than a year. She would also like to have the largest dose possible, so she can use the prescription for 2 months, instead of one. She explains that it is very hard to get off work and come in for appointments. The nurse's best response would be:
"The prescription dose is always started as low as possible and the refills are monitored to prevent abuse."
The nurse is teaching parents of a pediatric client diagnosed with ADHD. Teaching has been about the disorder and its treatment. The nurse determines that teaching has been effective when the parents state which?
"We need to remember that our son is not a bad kid; he just has difficulty with impulse control and attention."
A client taking a CNS stimulant may experience altered sleep patterns. What can the nurse instruct the client to do to help with altered sleep patterns? Select all that apply:
- Be active during the day. - Avoid other caffeine. - Administer the drug early in the day.
The nurse is aware that drug therapy is prescribed for children with ADHD under which circumstances? (Select all that apply.)
- Symptoms are moderate to severe. - Symptoms are present for several months. - Symptoms interfere in social, academic, or behavioral functioning
A presurgical client has reported a history of illicit amphetamine use. The nurse is concerned because of the effect this type of abuse has on what physiological functions? Select all that apply.
- central nervous system (CNS) - sympathetic nervous system (SNS)
A pediatric client has been prescribed dextroamphetamine (Adderall) 2.5 mg PO BID. How many mg would this client take each day?
5
A 75-year-old male client is given an order for a CNS stimulant secondary to a new diagnosis of narcolepsy. He begins to experience signs and symptoms of excessive CNS stimulation. The nurse knows that the client is likely to also experience an exacerbation of which preexisting condition?
Cardiac arrhythmias
Dexmethylphenidate has been prescribed to Scott, a 7-year-old boy who was diagnosed with ADHD. The mother asks how this medication will help her son. Which would be the most accurate description of the purpose of this medication?
Dexmethylphenidate will improve Scott's attention span so that he will be able to complete a task.
A 15-year-old boy who has been taking dextroamphetamine for the treatment of ADHD has been experiencing a depressed mood and a sense of hopelessness. He confides in the school nurse that he has begun taking his stepfather's antidepressant to improve his mood. After immediately phoning the boy's stepfather, the nurse learns that the drug in question is phenelzine (Nardil), a monoamine oxidase inhibitor (MAOI). The nurse should recognize that this combination of drugs creates a serious risk of what health problem?
Hypertension
The nurse is aware that CNS stimulants are prescribed for clients with ADHD because these medications have what effect on behavior and attention?
Improving
The client is a 45-year-old man who is obese. He is seeking help losing weight. He wants to be prescribed dextroamphetamine. Based on the client's history, what would contraindicate the use of this medication?
Myocardial infarction 2 months previously
A client taking modafinil (Provigil), for narcolepsy has recently needed an increased dosage. At a follow-up visit, the client is combative, confused, and has a low-grade fever. The nurse knows that this clinical presentation is most likely which?
Signs of toxicity from the medication
The nurse knows the medication methylphenidate is used to treat attention deficit hyperactivity disorder(ADHD). What type of medication is methylphenidate?
a central CNS stimulant
A 22-year-old client comes into the emergency department. He is highly active, and says his heart is pounding. On further questioning, he says he took several pills at a party. What type of medication does the nurse suspect he took at the party?
amphetamine
A nurse is obtaining baseline physical data from a 7-year-old patient who is to be started on dextroamphetamine for ADHD. After obtaining vital signs, height, and weight, the nurse will prepare the patient for an
electrocardiogram (ECG).
A nurse is assessing a client who is suspected of having attention deficit hyperactivity disorder (ADHD). Which is a characteristic of ADHD?
impulsiveness.
The client is admitted to the medical floor with a diagnosis of narcolepsy. The nurse can anticipate the health care provider to order which medication to treat this disorder?
modafinil
A client has recently been placed on modafinil 200 mg PO once daily. Modafinil (Provigil) is first-line pharmacologic therapy for:
narcolepsy.
The nurse is planning care for a client who has been prescribed a CNS stimulant. What should the nurse establish as the primary goal of therapy?
relieve the symptoms for which they were prescribed.
A nurse is providing care for a client diagnosed with attention deficit hyperactivity disorder (ADHD) who has been taking methylphenidate for several months. When monitoring for potential adverse effects, the nurse should include what assessments?
sleep patterns
The nurse is caring for a client with narcolepsy. Which potential medication will the nurse prepare to teach the client about? Select all that apply.
Modafinil Armodafinil Methylphenidate
A client with a history of drug and alcohol abuse has recently been diagnosed with attention deficit hyperactivity disorder (ADHD). The client requires treatment with medication. Which medication would the nurse anticipate to be prescribed for this client?
Atomoxetine (Strattera)
