Chapter 57 Prep U: Pharm
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 pediatric client has been prescribed dextroamphetamine (Adderall) 2.5 mg PO BID. How many mg would this client take each day?
5 mg
The client taking a CNS stimulant reports insomnia. The best option for the nurse in this case is to do which?
Administer the drug earlier in the day.
The nursing student learned in pharmacology class that drugs that affect the CNS do which of the following? (Check all that apply.)
Alter sensation Alter the interpretation of information in the brain Alter mood
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 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:
Avoid other caffeine. Be active during the day. Administer the drug early in the day.
The nurse is caring for a child receiving a central nervous system (CNS) stimulant who was admitted to the pediatric intensive care unit following repeated seizures after a closed head injury. The provider orders phenytoin to control seizures and lorazepam to be administered every time the child has a seizure. What is the nurse's priority action?
Call the provider and question the administration of phenytoin.
A 10-year-old child is being administered CNS stimulants for ADHD. What should the nurse instruct the parents to record periodically?
Weight and growth
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
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).
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."
The peditric client has been prescribed mehtylphenidate. Which statement should be included in the teaching plan for a client receiving methylphenidate?
"Adverse effects include hypertension and nervousness."
The parents of a child diagnosed with attention-deficit syndrome receives a prescription for a central nervous system (CNS) stimulant to treat their child. One of the parents asks the nurse, "I don't understand why we're giving a stimulant to calm our child down?" What is the nurse's best response?
"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."
The nurse is preparing to teach a client about the CNS stimulant which has been prescribed. When warning the client about potential sleeping difficulties, which steps will the nurse recommend to avoid these issues? Select all that apply.
Be active during the day. Administer the drug early in the day. Avoid caffeine products.
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
Which of the following effects can be noticed in a patient who has been administered amphetamines?
Decreased appetite
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.
When providing education to a patient who is taking dextroamphetamine, what would be a priority teaching point?
Dextroamphetamine should not be taken with other over-the-counter medications.
A 10-year-old boy is taking dextroamphetamine (Dexedrine) daily for ADHD. At each clinic visit, the nurse must assess the child. The priority assessment since he is on this medication would be which?
Height and weight
A nurse is assessing a client who is suspected of having attention deficit hyperactivity disorder (ADHD). Which is a characteristic of ADHD?
Impulsiveness
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 patient with obesity who recently became unemployed has been taking desoxyn for more than 9 months. The nurse thinks that the patient should stop this drug for which of the following reasons?
Long-term use can cause tolerance.
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 has recently been placed on modafinil 200 mg PO qd daily. Modafinil (Provigil) is first-line pharmacologic therapy for:
Narcolepsy
A pediatric client has been admitted to the floor and started on ritalin therapy for AHDH. The nurse knows that an important daily intervention for this client would be which?
Record a daily summary of client's behavior.
The home health nurse is gathering a client's medication prior to going to see the physician. The nurse cannot find the bottle for the methylphenidate, Daytrana. What would be the reason for this?
This is a transdermal patch medication.
What recommendation should the nurse provide to a client diagnosed with narcolepsy who is reluctant to rely on medication therapy?
maintaining regular sleeping and waking times to avoid periods of sleep deprivation
The main goal of therapy when using CNS stimulants is to:
relieve the symptoms for which they were prescribed.
