Chapter 57: Drug Therapy for ADHD and Narcolepsy

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 pediatric client has been prescribed methylphenidate (Ritalin). Which statement should be included in the teaching plan for a client receiving methylphenidate?

"Adverse effects include hypertension and nervousness."

A school-aged child has been taking methylphenidate for several months for the treatment of ADHD. The client's health record reveals a gradual 4% decline in body weight over the past three months. What is the nurse's priority action?

Facilitate follow-up with the health care provider.

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.

When would treatment with medication be considered for a child with attention deficit hyperactivity disorder (ADHD)? Select all that apply.

When symptoms are moderate to severe When symptoms interfere with social and academic functioning When symptoms interfere with behavioral functioning

Methylphenidate will be used to treat a 9-year-old boy's ADHD. In light of this drug's most common adverse effects, the nurse who is working with the family should implement what strategy?

A plan to address the boy's loss of appetite

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

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 diagnosed with narcolepsy expresses reluctance to rely on medication therapy. What recommendation should the nurse provide?

maintaining regular sleeping and waking times to avoid periods of sleep deprivation

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 school-aged child has been prescribed extended-release methylphenidate for the treatment of ADHD. At the most recent meeting with the family, the child's parents state that they have not witnessed significant improvements in their child's behavior. What statement by the family should prompt the nurse to provide additional education?

"I open the capsule and sprinkle it on his cereal at the correct time."

The parents of a child diagnosed with attention-deficit hyperactivity disorder (ADHD) 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."

A client asks to have a year's worth of prescription refills for methylphenidate (Ritalin), explaining that it is very hard to leave work for clinic appointments. How should the nurse respond to that request to best assure client safety?

"The prescription dose is always started as low as possible, and the refills are monitored to prevent abuse."

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 patient suffers from narcolepsy. Which of the following aspects of patient teaching should be provided?

Avoid working shifts.

A 4-year-old child is brought to the pediatric clinic by his mother. She states, "I don't know what to do with him. He is in constant motion. He won't sit for more than a few seconds and he is doing something else. He often throws his toys and yells loudly, even compared with other kids his age." The child is diagnosed with attention deficit hyperactivity disorder. Which of the following medications will most likely be administered in conjunction with treatment?

Central nervous system stimulants

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 (Ritalin), the nurse is justified in considering a history of what health problem?

Hyperactivity

A patient visits the occupational health office of the factory in which he works. He has fallen asleep on the line and has a history of muscle weakness. This instance is not the first time he has fallen asleep on the line. From what disease process does the occupational health nurse suspect the patient is suffering?

Narcolepsy

An adult client has been diagnosed with ADHD following many years of challenges with employment and relationships. The client was prescribed methylphenidate several weeks ago, and now reports to the nurse, "I'm feeling really nervous and restless when I'm on my medication and I can't get to sleep at night." What is the nurse's priority action?

Report the finding to the health care provider promptly.

A boy has been diagnosed with ADHD and has been prescribed Ritalin. The boy's mother tells the nurse that she does not understand why a stimulant would help him, stating, "If anything, he's completely overstimulated, not understimulated!" What should the nurse explain to the mother about the therapeutic use of Ritalin?

Ritalin helps with the symptoms of ADHD, but the reasons for this are not well understood.

The parents of a male child with attention deficit-hyperactivity disorder (ADHD) bring the child to the health care provider's office for a follow-up visit. During the visit, the parents tell the nurse that the child receives his first dose of Ritalin at 7:30 every morning. The child's teacher and school nurse have reported that his ADHD symptoms return just before his second daily dose, which coincides with the lunch period at noon. Which might the nurse suggest to help better control the child's symptoms during school hours?

Talking to the health care provider about switching to a longer acting preparation

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

After experiencing two workplace accidents in which he fell asleep, a 30-year-old construction worker has been diagnosed with narcolepsy. The patient admits that he is embarrassed to receive this diagnosis and is adamant that no one find out about it. The nurse should respond to the patient by explaining what aspect of the etiology?

"This is the result of neurological factors over which you have no direct control."

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:

Administer the drug early in the day. Avoid other caffeine. Be active during the day.