NSG 211 ADHD

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 nurse is aware that medication dosage for a child with ADHD is stopped occasionally for what reason?

Evaluation of treatment regimen A drug holiday (i.e., stopping drug therapy) is recommended at least annually to evaluate the child's treatment regimen. Dosage adjustments are usually needed as the child grows and hepatic metabolism slows. Also, drug holidays decrease weight loss and growth suppression.

A nurse is studying the brain images of children with attention deficit hyperactivity disorder (ADHD). In these images, the nurse would find abnormalities related to which area of the brain?

Frontal lobe Studies have proven that ADHD is associated with malfunction of the frontal lobe. Decreased metabolism and decreased perfusion to the frontal lobe are the physiological alterations known to cause ADHD

The nurse is working closely with the parent of a 6-year-old client who was just diagnosed with attention deficit/hyperactivity disorder (ADHD). Which methods used in behavior modification would be appropriate for this child? Select all that apply. Give short and clear explanations Wait a few days to punish Provide a structured environment Give medication only when needed

Give short and clear explanations Provide a structured environment Be fair but firm, and stick to rules

The nurse is aware that CNS stimulants are prescribed for clients with ADHD because these medications have what effect on behavior and attention?

Improving

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 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). This would be important for ruling out any cardiovascular abnormalities that CNS stimulants might exacerbate, especially in this patient who is 7 years old.

The nurse is participating in a family meeting with the parents of a child diagnosed with attention deficit hyperactivity disorder (ADHD) and prescribed dextroamphetamine. The nurse should discuss what black box warning associated with this medication?

potential for abuse

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 sexual function pupillary response orientation to person, place, and time

sleep patterns

The mother of a 10-year-old boy with attention deficit hyperactivity disorder (ADHD) contacts the school nurse. She is upset because her son has been made to feel different by his peers because he has to visit the nurse's office for a lunchtime dose of medication. The boy is threatening to stop taking his medication. How should the nurse respond?

"You may want to talk to your physician about an extended-release medication."

A nurse is speaking to the parents of a child with attention deficit hyperactivity disorder (ADHD). The parents ask the nurse about the reason for the child's underachievement in academics. What explanation given by the nurse is most appropriate?

"Your child has trouble following the teacher's directions."

A nurse who is providing care on a pediatric client has conducted a medication reconciliation. In light of the fact that the client takes methylphenidate, the nurse is justified in considering a history of what health problem?

Hyperactivity

A client, prescribed dextroamphetamine for attention deficit hyperactivity disorder (ADHD) has developed a common adverse effect of the medication since beginning therapy. Which initial intervention should the client be encouraged to implement?

Increase fiber intake. Constipation is a common adverse effect of dextroamphetamine. A client who is experiencing constipation should be instructed to increase fiber in the diet.

A child with attention deficit hyperactivity disorder (ADHD) has been prescribed dextroamphetamine. For what effects should the nurse tell the parents to monitor the child? Select all that apply. Insomnia Weight loss Appetite suppression Hypotension Weight gain

Insomnia Weight loss Appetite suppression

An adolescent client has been taking dextroamphetamine for the treatment of attention deficit hyperactivity disorder (ADHD) for 3 years, achieving significant improvements in behavior and mood. When assessing the child during a scheduled follow-up appointment, the nurse should prioritize what physical assessment to monitor for a potential adverse reaction to the therapy?

Measurement of height and body weight Suppression of weight and height may occur in children taking amphetamines, and the nurse ensures that growth is monitored during drug therapy.

The nurse is caring for a 10-year-old recently diagnosed with attention deficit hyperactivity disorder (ADHD). The nurse would expect to provide teaching regarding which medication?

Methylphenidate

Which medication is effective in 70% to 80% of children with attention deficit hyperactivity disorder (ADHD)?

Methylphenidate

A child with an existing diagnosis of attention deficit hyperactivity disorder shows signs and symptoms of depression. Which would most likely be prescribed?

Selective serotonin and norepinephrine reuptake inhibitor (SSNRI) Antidepressant medications, most likely SSNRIs, are used for anxiety, depression, and primarily for ADHD.

The parents of a child with attention deficit hyperactivity disorder (ADHD) bring the child for a follow-up visit. During the visit, they tell the nurse that the child receives the first dose of methylphenidate at about 7:30 a.m. every morning before leaving for school. The teacher and school nurse have noticed a return in the child's overactivity and distractibility just before lunch. The child's second dose is scheduled for about 12 p.m. Which might the nurse suggest as a possible solution to control the child's symptoms a bit more effectively?

Switch to a longer-acting preparation.

A nurse is working with a child undergoing behavioral modification therapy for attention deficit hyperactivity disorder (ADHD). The nurse finds that the child is thin. What could be the most likely reason for this observation?

The child cannot sit through meals.

A nurse is speaking to the peers of a child with attention deficit hyperactivity disorder (ADHD). The nurse finds that these children do not like the child and do not want to include the child during play. What are the likely reasons for the children feeling this way? Select all that apply. The child cannot move or play as quickly as the other children. The child abuses other children. The child is not cooperative while playing. The child constantly interrupts while playing. The child doesn't follow the rules of the game.

The child is not cooperative while playing. The child constantly interrupts while playing. The child doesn't follow the rules of the game.

Methylphenidate has been prescribed to a child diagnosed with attention deficit hyperactivity disorder (ADHD). What information should the nurse provide both the child and the parents to ensure effective administration of the medication? Select all that apply. The last dose should be taken at least 6 hours before the child's bedtime. The child's first dose should be taken upon awakening. Dosing should occur every 6 hours around the clock. Administration should be scheduled at times when the symptoms are most severe. Administration should be coordinated with the timing of the child's meals.

The child's first dose should be taken upon awakening. The last dose should be taken at least 6 hours before the child's bedtime.

A nurse is caring for a child with attention deficit hyperactivity disorder. The nurse asks the child to draw pictures of the child and family members. What is the most likely rationale for this intervention?

To help the child self-express Creative play techniques such as having children draw pictures of themselves and of their family are useful for children who are unwilling to express themselves verbally.

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 school-age boy is on methylphenidate for ADHD. What negative side effect should the mother be advised to monitor for in the child?

appetite suppression

The nurse in the well-child clinic observes that a 5-year-old child in the waiting room is having trouble using a crayon to color. During the visit, the same child climbs off the table several times even after the nurse has asked him to stay on the table. Each time the nurse reminds him he says, "Oh, yeah," and happily climbs back up. The nurse suspects that the child has:

attention deficit hyperactive disorder (ADHD). The child with ADHD may have these characteristics: Impulsiveness, easy distractibility, frequent fidgeting or squirming, difficulty sitting still, problems following through on instructions despite being able to understand them, inattentiveness when being spoken to, frequent losing of things, going from one uncompleted activity to another, difficulty taking turns, frequent excessive talking, and engaging in dangerous activities without considering the consequences.

A nurse is assessing a 10-year-old child who is displaying behaviors that are consistent with oppositional defiance disorder. When conducting the assessment, the nurse should also assess for which co-morbidity?

attention deficit hyperactivity disorder