Videbeck: Ch 22: Neurodevelopmental
The nurse is assessing an adult client with ADD. The nurse expects which of the following to be present? (A) Difficulty remembering appointments (B) Falling asleep at work (C) Problems getting started on a project (D) Lack of motivation to do tasks
(A) Difficulty remembering appointments
Teaching for methylphenidate (Ritalin) should include which of the following? (A) Give the medication after meals. (B) Give the medication when the child becomes overactive. (C) Increase the child's fluid intake when he or she is taking the medication. (D) Take the child's temperature daily.
(A) Give the medication after meals.
Which of the following is used to treat enuresis? (A) Imipramine (Tofranil) (B) Methylphenidate (Ritalin) (C) Olanzapine (Zyprexa) (D) Risperidone (Risperdal)
(A) Imipramine (Tofranil)
A 7-year-old child with ADHD is taking clonidine (Kapvay). Common side effects include (A) appetite suppression. (B) dizziness. (C) dry mouth. (D) hypotension. (E) insomnia. (F) nausea.
(B) dizziness. (C) dry mouth. (D) hypotension.
A teaching plan for the parents of a child with ADHD should include (A) allowing as much time as needed to complete any task. (B) allowing the child to decide when to do homework. (C) giving instructions in short simple steps. (D) keeping track of positive comments that the child is given. (E) providing a reward system for completion of daily tasks. (F) spending time at the end of the day reviewing the child's behavior.
(C) giving instructions in short simple steps. (D) keeping track of positive comments that the child is given. (E) providing a reward system for completion of daily tasks.
The nurse would expect to see all the following symptoms in a child with ADHD, except (A) easily distracted and forgetful. (B) excessive running, climbing, and fidgeting. (C) moody, sullen, and pouting behavior. (D) interrupts others and can't take turns.
(C) moody, sullen, and pouting behavior.
A child is taking pemoline (Cylert) for ADHD. The nurse must be aware of which of the following side effects? (A) Decreased thyroid-stimulating hormone (B) Decreased red blood cell count (C) Elevated white blood cell count (D) Elevated liver function tests
(D) Elevated liver function tests
The nurse recognizes which of the following as a common behavioral sign of autism? (A) Clinging behavior toward parents (B) Creative imaginative play with peers (C) Early language development (D) Indifference to being hugged or held
(D) Indifference to being hugged or held
The nurse is teaching a 12-year-old with intellectual disability about medications. Which of the following interventions is essential? (A) Speak slowly and distinctly. (B) Teach the information to the parents only. (C) Use pictures rather than printed words. (D) Validate client understanding of teaching.
(D) Validate client understanding of teaching.
What suggestions for managing the home environment might be helpful for the parents?
Provide supervision when Dixie is with her brother, and help her learn to play gently with him. Do not forbid her to touch him, but teach her the proper ways to do so. Give Dixie directions in a clear, step-by-step manner, and assist her to follow through and complete tasks. Provide a quiet place with minimal distraction for activities that require concentration, such as homework. Try to establish a routine for getting up and dressing, eating meals, going to school, doing homework, and playing; don't change the routine unnecessarily. Structured expectations will be easier for Dixie to follow. Remember to recognize Dixie's strengths and provide positive feedback frequently to boost her self-esteem and foster continued progress.
What teaching will the nurse include about methylphenidate?
Ritalin is a stimulant medication that is effective for 70% to 80% of children with ADHD by decreasing hyperactivity and impulsivity and improving the child's attention. Ritalin can cause appetite suppression and should be given after meals to encourage proper nutrition. Substantial, nutritious snacks between meals are helpful. Giving the medication in the daytime helps avoid the side effect of insomnia. Parents should notice improvements in a day or two. Notify the physician or return to the clinic if no improvements in behavior are noted.
What information will the nurse provide about ADHD?
The exact cause of ADHD is not known, but it is not due to faulty parenting or anything the parents have done. Taking medications will be helpful with behavioral symptoms, but other strategies are needed as well. The medication will help control symptoms, so Dixie can participate in school, make friends, and so forth.
