Chapter 57 PrepU
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." "The medication is usually taken just before bedtime." "The drug may cause weight gain." "There is no risk of dependence."
"Adverse effects include hypertension and nervousness."
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? Diabetes Cardiac arrhythmias Gout Hyperparathyroidism
Cardiac arrhythmias
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 risk of hemorrhagic stroke anticholinergic effects hyperglycemic crisis
potential for abuse
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). electromyelogram (EMG). electroencephalogram (EEG). electrophysiologic study (EPS).
electrocardiogram (ECG).
The client taking a CNS stimulant reports insomnia. The best option for the nurse in this case is to do which? Administer the drug 2 hours before bedtime. Administer the drug earlier in the day. Administer the drug right before bedtime. Hold the drug.
Administer the drug earlier in the 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. Administer the drug early in the day. Take frequent naps throughout the day. Avoid caffeine products. Stop taking the medication. Be active during the day.
Administer the drug early in the day. Avoid caffeine products. Be active during the day.
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 after breakfast and after lunch. Always take the drug in the morning 30 to 45 minutes before breakfast and lunch. Always take the drug in the morning before breakfast and before going to bed at night. Always take the drug 30 minutes before lunch and dinner.
Always take the drug in the morning 30 to 45 minutes before breakfast and lunch.
The use of CNS stimulants is contraindicated in clients with which conditions? (Select all that apply.) Epilepsy COPD Glaucoma Diabetes GERD
Epilepsy COPD Glaucoma
The nurse is explaining diet restrictions to a client receiving dexmethylphenidate. Which drinks should the nurse encourage the client to avoid? Select all that apply. Black tea Fruit juice Coffee Cola drinks Milk
Black tea Coffee Cola drinks
An adolescent client's ADHD has not responded to first-line therapies and the care team has agreed on a trial of dextroamphetamine. How should the nurse best address the safety risks associated with this medication? Monitor closely for suicidal ideation or self-harm. Create a meal plan with the family prior to starting the medication. Educate about the risk for abuse and monitor the client accordingly. Provide anticipatory guidance about sleep disturbances.
Educate about the risk for abuse and monitor the client accordingly.
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? Anxiety Respiratory depression Obesity Hyperactivity
Hyperactivity
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 Normal side effects of taking CNS stimulants A result of a concomitant infection Unrelated to taking this medication
Signs of toxicity from the medication
The nurse is providing ongoing care for an adolescent client whose ADHD is being treated with dextroamphetamine and amphetamine. What assessment finding should prompt the nurse to investigate the possibility of drug diversion? The client's medication supply often runs out ahead of schedule. The client denies the medication is working, but others notice improved behavior. The client requests extended-release rather than immediate-release medication. The client's parents state that he constantly needs to be reminded to take the medication.
The client's medication supply often runs out ahead of schedule.
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? Nurses often misplace medication bottles. This is an IV medication. This is an IM medication. This is a transdermal patch medication.
This is a transdermal patch medication.
A client who is obese is to start receiving amphetamine as part of the treatment. Which factor should the nurse prioritize in the preadministration assessment? Temperature Weight Blood glucose level Arterial blood gas results
Weight
A 10-year-old child is being administered CNS stimulants for ADHD. What should the nurse instruct the parents to record periodically? Social interaction Weight and growth Voiding pattern Sleeping pattern
Weight and growth
The nurse knows the medication methylphenidate is used to treat attention deficit hyperactivity disorder(ADHD). What type of medication is methylphenidate? a selective serotonin reuptake inhibitor (SSRI) a central CNS stimulant a respiratory stimulant an anorectic agent
a central CNS stimulant
The child is diagnosed with attention deficit hyperactivity disorder (ADHD). Which medication will most likely be administered in conjunction with treatment? ACE inhibitors selective serotonin reuptake inhibitors (SSRIs) central nervous system (CNS) stimulants monoamine oxidase inhibitors (MAOIs)
central nervous system (CNS) stimulants
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. Vision. body temperature. blood pressure.
height and weight.
Which of the following effects can be noticed in a patient who has been administered amphetamines? Decreased appetite Low blood pressure Drowsiness Depression
Decreased appetite
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? The cost is prohibitive when prescribed in a large number. It reduces the likelihood of drug dependence or diversion. Changes in dosages are common. HMOs will not reimburse the cost for larger numbers.
It reduces the likelihood of drug dependence or diversion.
A child was diagnosed with attention-deficit hyperactivity disorder (ADHD), 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 breath sounds and respiratory rate urine output and kidney function electrocardiogram (ECG) and echocardiogram
weight and height
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." "It helps energize the child so they use up all of their available energy and then they can focus on quieter stimuli." "No one truly understands why it works, but it has been demonstrated to be very effective in treating attention-deficit." "The drug works really well, and you will see a tremendous change in your child within a few weeks without any other treatment."
"It helps the reticular activating system, a part of the brain, to be more selective in response to incoming stimuli."