Pediatric Nursing: ADHD Management Scenario
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Questions and Answers

What is a potential side effect of administering albuterol to a patient with asthma?

  • Increased drowsiness
  • Decreased blood pressure
  • Increased heart rate (correct)
  • Increased gastrointestinal (GI) motility

    • Which side effect is NOT generally associated with adrenergic agonists?

  • Tachycardia
  • Hypertension
  • Increased drowsiness (correct)
  • Decreased GI motility

    • Which beta blocker would be the safest choice for a patient with asthma and cardiovascular disease?

  • Pindolol (Visken)
  • Metoprolol (Lopressor) (correct)
  • Propranolol (Inderal)
  • Nadolol (Corgard)

    • What is the main benefit of Metoprolol over other beta blockers in patients with both asthma and cardiovascular disease?

    <p>Reduced bronchoconstriction risk</p> Signup and view all the answers

    Which receptor do selective beta2 agonists like albuterol preferentially act on?

    <p>Beta2</p> Signup and view all the answers

    What side effect is commonly associated with beta1 receptor activation by adrenergic agonists?

    <p>Increased heart rate</p> Signup and view all the answers

    What is the expected outcome when a nurse administers epinephrine to a patient experiencing an anaphylactic reaction?

    <p>Decreased urine output</p> Signup and view all the answers

    Why might a nurse suspect that a patient experiencing asthma exacerbation has overused albuterol?

    <p>High doses of albuterol may affect beta1 receptors, causing an increase in heart rate.</p> Signup and view all the answers

    What action should a nurse take upon noting erythema and swelling at the IV insertion site of a patient receiving intravenous dopamine (Intropin)?

    <p>Notify the provider of a need for phentolamine mesylate (Regitine).</p> Signup and view all the answers

    What instruction should a nurse give to a patient using phenylephrine HCl (Neo-Synephrine) nasal spray to treat congestion from a viral upper respiratory infection?

    <p>Use this product for a maximum of 3 days.</p> Signup and view all the answers

    When teaching a patient about taking atenolol (Tenormin) for hypertension, what information should the nurse include?

    <p>The patient should rise slowly from a chair or bed.</p> Signup and view all the answers

    A patient taking atenolol (Tenormin) reports dizziness, nausea, vomiting, and decreased libido. What should the nurse do?

    <p>Hold the next dose until notifying the provider of these side effects.</p> Signup and view all the answers

    What is the primary purpose of benztropine (Cogentin) in patients with Parkinson's disease?

    <p>To suppress tremors and lessen muscle rigidity</p> Signup and view all the answers

    Which side effect would prompt the nurse to notify the provider in a patient who received atropine sulfate preoperatively?

    <p>Absent bowel sounds</p> Signup and view all the answers

    What type of drug would a patient with irritable bowel syndrome most likely receive for treatment?

    <p>An anticholinergic</p> Signup and view all the answers

    Which statement is true about phentermine?

    <p>It is indicated for short-term use in treating obesity.</p> Signup and view all the answers

    When taking an anticholinergic medication, what should patients do to counter the side effect of dry mouth?

    <p>Use gum or lozenges</p> Signup and view all the answers

    What diagnostic test may be ordered to assist with a diagnosis of ADHD in a child with symptoms of inattention and hyperactivity?

    <p>EEG</p> Signup and view all the answers

    Which statement by a patient indicates a need for further teaching about bethanechol (Urecholine)?

    <p>'Excessive sweating is a normal reaction to this medication.'</p> Signup and view all the answers

    Why should methylphenidate be taken before breakfast and lunch?

    <p>It can cause insomnia, and taking it before meals can help with this side effect.</p> Signup and view all the answers

    What would be a concerning health history that the nurse should investigate before administering neostigmine to a male patient with myasthenia gravis?

    <p>Benign prostatic hypertrophy</p> Signup and view all the answers

    What should a parent understand about giving methylphenidate to their child for ADHD?

    <p>The child should avoid caffeine-containing products.</p> Signup and view all the answers

    What would be a crucial monitoring parameter when a patient is prescribed bethanechol (Urecholine)?

    <p>Heart rate variations</p> Signup and view all the answers

    What advice should a nurse give to a parent of a child on amphetamine for ADHD who asks about over-the-counter cold medications?

    <p>Avoid products with pseudoephedrine or caffeine.</p> Signup and view all the answers

    Why are anticholinergic drugs like benztropine used in Parkinson's disease?

    <p>To decrease tremors and muscle rigidity</p> Signup and view all the answers

    For a child taking methylphenidate, which assessments are particularly important during clinic visits?

    <p>Height, weight, and blood pressure</p> Signup and view all the answers

    During which stage of sleep do vivid dreams occur?

    <p>Rapid eye movement (REM) sleep</p> Signup and view all the answers

    When do nightmares commonly occur in children?

    <p>Nonrapid eye movement (NREM) sleep</p> Signup and view all the answers

    What non-pharmacologic measure may help with sleep difficulties according to the text?

    <p>&quot;Get out of bed at the same time each morning.&quot;</p> Signup and view all the answers

    Which stage of sleep is related to nightmares in children?

    <p>Nonrapid eye movement (NREM) sleep</p> Signup and view all the answers

    What is the recommended approach for promoting sleep without medication?

    <p>&quot;Exercise in the evening to promote bedtime fatigue.&quot;</p> Signup and view all the answers

    Which statement best describes the action of an indirect-acting cholinergic agonist?

    <p>Inhibits cholinesterase</p> Signup and view all the answers

    Why are direct-acting cholinergic agonist drugs selective to muscarinic receptors sometimes considered non-specific?

    <p>Muscarinic receptors are present in many different tissues</p> Signup and view all the answers

    If a patient has a blood pressure of 90/60 mm Hg, what is the appropriate action before administering bethanechol (Urecholine) for urinary retention?

    <p>Hold the medication and notify the provider of decreased blood pressure</p> Signup and view all the answers

    After voiding 800 mL of urine, a patient taking bethanechol reports a loose stool but no cramping. Blood pressure is 110/70 mm Hg. What should the nurse do?

    <p>Record urine output and blood pressure and continue monitoring</p> Signup and view all the answers

    What does it mean when a nurse is advised to use sympathomimetic drugs with caution in diabetic patients?

    <p>The drugs may cause hyperglycemia</p> Signup and view all the answers

    What is the appropriate action if a nurse learns a patient with diabetes mellitus has been ordered to receive pseudoephedrine for nasal congestion?

    <p>Hold the medication and contact the provider</p> Signup and view all the answers

    What action should be taken if a nursing student asks why a direct-acting cholinergic agonist selective to muscarinic receptors is described as non-specific?

    <p>Muscarinic receptors are present in many different tissues</p> Signup and view all the answers

    What should a nurse do if preparing to administer an indirect-acting cholinergic agonist drug?

    <p>Hold the medication and contact the provider.</p> Signup and view all the answers

    When preparing to give bethanechol (Urecholine) for urinary retention, what should the nurse do if the patient has a blood pressure of 120/80 mm Hg?

    <p>Administer the drug and monitor urine output.</p> Signup and view all the answers

    What is the appropriate action for the nurse to take when a parent expresses concern about their child experiencing nausea, vomiting, and headaches after taking methylphenidate for ADHD?

    <p>Ask the child whether the drug is being taken as prescribed.</p> Signup and view all the answers

    What does a parent's statement about consulting a pharmacist when giving OTC medications with methylphenidate indicate?

    <p>Awareness of potential interactions between OTC medications and methylphenidate.</p> Signup and view all the answers

    What is an appropriate response by the nurse when asked about weight loss medications for an obese 10-year-old child?

    <p>Children under 12 years of age should not use weight loss drugs.</p> Signup and view all the answers

    Which drug is indicated for treating neonatal apnea in infants experiencing bradycardia and apnea?

    <p>Caffeine citrate</p> Signup and view all the answers

    What potential adverse effects should a nurse anticipate when a patient presents after consuming caffeine tablets, coffee, and energy drinks?

    <p>Arrhythmias and convulsions may occur.</p> Signup and view all the answers

    What medication would a nurse expect a provider to order for a patient diagnosed with narcolepsy and reporting difficulty staying awake during the daytime?

    <p>Modafinil</p> Signup and view all the answers

    What is a common side effect of beta-adrenergic blockers?

    <p>Increased heart rate</p> Signup and view all the answers

    What should a patient do if experiencing side effects from beta-blockers?

    <p>Discuss them with the healthcare provider</p> Signup and view all the answers

    What are high dosages of albuterol (Proventil) inhaler known to potentially cause?

    <p>Increase in heart rate</p> Signup and view all the answers

    How do alpha-adrenergic blockers help in treating Raynaud’s disease?

    <p>Vasodilation</p> Signup and view all the answers

    What is a crucial skill for a patient's family to learn when the patient is on beta blockers?

    <p>Monitoring heart rate and blood pressure</p> Signup and view all the answers

    What category does Reserpine fall under?

    <p>Adrenergic neuron antagonist</p> Signup and view all the answers

    What is neostigmine used for?

    <p>Myasthenia gravis</p> Signup and view all the answers

    Where should a patient apply the transdermal scopolamine patch?

    <p>Behind the ear</p> Signup and view all the answers

    Why should a patient change the transdermal scopolamine patch every three days?

    <p>To maintain effectiveness</p> Signup and view all the answers

    What condition would cause a nurse to hold benztropine medication for a patient with Parkinson's disease?

    <p>Glaucoma</p> Signup and view all the answers

    What action should the nurse take if a patient reports a dry mouth after receiving atropine?

    <p>Palpate the patient’s bladder</p> Signup and view all the answers

    When should a patient with myasthenia gravis use benztropine with caution?

    <p>Myasthenia gravis</p> Signup and view all the answers

    Which medication is used to treat sinus bradycardia?

    <p>Atropine sulfate</p> Signup and view all the answers

    Why should a nurse hold the administration of tolterodine tartrate in a patient with incontinence?

    <p>Absent bowel sounds</p> Signup and view all the answers

    What is donepezil commonly used to treat?

    <p>Alzheimer's disease</p> Signup and view all the answers

    What is a common side effect that patients can experience with the use of phentermine?

    <p>Headaches</p> Signup and view all the answers

    Which diagnostic test is NOT helpful in diagnosing attention-deficit/hyperactivity disorder (ADHD)?

    <p>Electrocardiogram (ECG)</p> Signup and view all the answers

    A patient with ADHD taking methylphenidate is experiencing insomnia. What advice should the nurse give regarding the timing of medication administration?

    <p>Take the medication before breakfast and lunch</p> Signup and view all the answers

    What is a significant benefit of using phentermine for obesity treatment?

    <p>Short-term weight loss support</p> Signup and view all the answers

    What class of drug is phentermine based on its Schedule IV classification as a controlled substance?

    <p>Stimulant</p> Signup and view all the answers

    Why is an Electroencephalogram (EEG) ordered for a child suspected of having ADHD?

    <p>To evaluate brain wave patterns</p> Signup and view all the answers

    Which stage of sleep is associated with vivid dreams?

    <p>Rapid eye movement (REM) sleep</p> Signup and view all the answers

    During which stage of sleep do nightmares occur in children?

    <p>Nonrapid eye movement (NREM) sleep</p> Signup and view all the answers

    What non-pharmacologic measure can help promote sleep?

    <p>Get out of bed at the same time each morning</p> Signup and view all the answers

    Which barbiturate is an intermediate-acting agent helpful in sustaining sleep?

    <p>Butabarbital</p> Signup and view all the answers

    What is indicated for use in newborns with respiratory distress?

    <p>Caffeine citrate</p> Signup and view all the answers

    What can cause cardiac arrhythmias and seizures when consumed excessively?

    <p>Psychological dependence on caffeine</p> Signup and view all the answers

    What medication is given to treat narcolepsy?

    <p>Modafinil</p> Signup and view all the answers

    'Anorexiants should not be given to children under what age?'

    <p>'12 years'</p> Signup and view all the answers

    What drug could induce arrhythmias and convulsions when taken excessively?

    <p>Caffeine</p> Signup and view all the answers

    What is the maximum recommended dose of benzodiazepine for sleep aid?

    <p>10 mg</p> Signup and view all the answers

    Why should a patient taper the dose gradually when stopping benzodiazepine used as a sleep aid?

    <p>Withdrawal</p> Signup and view all the answers

    What is the purpose of administering a hypnotic medication the night before surgery?

    <p>To decrease the amount of general anesthesia needed</p> Signup and view all the answers

    What is the recommended timing for taking methylphenidate twice daily?

    <p>30-45 minutes before breakfast and lunch</p> Signup and view all the answers

    Which type of medication is given during surgery in balanced anesthesia?

    <p>Inhaled anesthetic</p> Signup and view all the answers

    What is a crucial reason for avoiding products containing caffeine when a child is taking methylphenidate for ADHD?

    <p>Caffeine can worsen the side effects of methylphenidate</p> Signup and view all the answers

    Why is it essential to ask about drug and alcohol use during a preoperative assessment?

    <p>Changes in anesthesia type and dose may be required</p> Signup and view all the answers

    Why should a child taking amphetamine for ADHD avoid products with pseudoephedrine or caffeine?

    <p>To avoid additional stimulation</p> Signup and view all the answers

    When does a patient who received isoflurane to induce anesthesia generally recover consciousness?

    <p>In 1 hour</p> Signup and view all the answers

    What should be closely monitored in a child taking methylphenidate due to potential medication side effects?

    <p>Height, weight, and blood pressure</p> Signup and view all the answers

    What is the appropriate initial action if a child on methylphenidate shows signs of nausea, vomiting, and hyperactivity?

    <p>Ask about medication adherence</p> Signup and view all the answers

    Why should a parent consult a pharmacist before giving their child OTC medications while on methylphenidate?

    <p>To prevent interactions with stimulants in OTC products</p> Signup and view all the answers

    What should a nurse do when assessing a child taking methylphenidate who reports recent nausea, vomiting, and headaches?

    <p>Ask the child about medication adherence</p> Signup and view all the answers

    Why is it significant for a parent to understand that behavioral therapy may still be necessary alongside medication therapy for ADHD?

    <p>&quot;Behavioral therapy can complement medication effects&quot;</p> Signup and view all the answers

    Why should patients taking benzodiazepines like alprazolam avoid alcohol?

    <p>Alcohol can enhance the sedative effects of the medication.</p> Signup and view all the answers

    Which medication is recommended for older adults experiencing difficulty falling asleep?

    <p>Temazepam</p> Signup and view all the answers

    What is the primary ingredient in over-the-counter sleep aids?

    <p>Antihistamine</p> Signup and view all the answers

    Which drug is classified as a melatonin receptor agonist?

    <p>Ramelteon</p> Signup and view all the answers

    What effect might a patient experience after taking Zolpidem (Ambien) for several weeks?

    <p>Hangover</p> Signup and view all the answers

    When should a patient take Zolpidem tartrate (Ambien) for sleep according to the teaching?

    <p>At bedtime</p> Signup and view all the answers

    'Why might a bed alarm be used for older patients receiving flurazepam?'

    <p>To prevent falls</p> Signup and view all the answers

    What is the most common cause of epilepsy according to the text?

    <p>Of unknown origin</p> Signup and view all the answers

    Why are anticonvulsants usually taken throughout a patient's lifetime?

    <p>Stopping the medication can lead to seizure recurrence</p> Signup and view all the answers

    What age-related factor influences phenytoin dosage in children?

    <p>Children with rapid metabolism may need higher doses</p> Signup and view all the answers

    What is the cause of reddened gums that bleed easily in patients on phenytoin?

    <p>Adverse effect of phenytoin</p> Signup and view all the answers

    What should a nurse do if a patient's random serum phenytoin level is 18 mcg/mL?

    <p>Administer the dose as prescribed</p> Signup and view all the answers

    Why is it important for children on phenytoin to have their dosage adjusted?

    <p>Due to their decreased drug metabolism rate</p> Signup and view all the answers

    What action should a nurse take when administering phenytoin to an 80-year-old patient?

    <p>Administer the dose as ordered</p> Signup and view all the answers

    What is a common adverse effect of phenytoin experienced by patients?

    <p>Drowsiness and fatigue</p> Signup and view all the answers

    What serum drug level range is considered therapeutic for phenytoin?

    <p>10-20 mcg/mL</p> Signup and view all the answers

    What is a common age-related consideration for phenytoin dosing in pediatric patients?

    <p>Children usually require higher doses than adults due to rapid metabolism.</p> Signup and view all the answers

    How does ethosuximide (Zarontin) work as an antiepileptic drug?

    <p>Suppressing calcium influx</p> Signup and view all the answers

    What is the most appropriate next step when a patient has a serum carbamazepine level of 18 mcg/mL?

    <p>Ask the patient about usual dietary preferences</p> Signup and view all the answers

    What aspect of a patient's medical history would be concerning when starting therapy with valproic acid (Depakote) for epilepsy?

    <p>Liver disease</p> Signup and view all the answers

    Why should a pregnant woman taking anticonvulsants receive vitamin K toward the end of her pregnancy?

    <p>Vitamin K inhibitor neutralization</p> Signup and view all the answers

    What percentage of children who experience febrile seizures are likely to develop epilepsy?

    <p>A large percentage develop epilepsy</p> Signup and view all the answers

    For a 25-year-old female starting phenytoin for epilepsy while on oral contraceptives, what advice would the nurse give?

    <p>Use backup contraception with oral contraceptives</p> Signup and view all the answers

    What should a parent understand about a child with a history of febrile seizures and the likelihood of developing epilepsy?

    <p>'A small percentage develop epilepsy'</p> Signup and view all the answers

    'A 5-year-old child who had a febrile seizure is at high risk of developing epilepsy.' - Is this statement true or false?

    <p>'False'</p> Signup and view all the answers

    What is the recommended route for administering phenytoin to older patients?

    <p>Directly into a large vein via a central line or PICC</p> Signup and view all the answers

    What is the reason for avoiding intramuscular injection of phenytoin?

    <p>Very irritating to tissues</p> Signup and view all the answers

    What blood test should the nurse discuss with the provider for a patient taking phenytoin for several years?

    <p>Blood glucose</p> Signup and view all the answers

    What action is appropriate if a patient presents with reddish-brown urine while taking phenytoin?

    <p>Reassure the patient that it is a harmless side effect</p> Signup and view all the answers

    What action is necessary if a female patient taking phenytoin becomes pregnant?

    <p>Discontinue phenytoin and discuss alternative options</p> Signup and view all the answers

    Which antiepileptic medication is specifically used to treat absence seizures?

    <p>Ethosuximide (Zarontin)</p> Signup and view all the answers

    What drug should the nurse anticipate administering first to an intubated child having a seizure for 20 minutes in the emergency department?

    <p>Diazepam (Valium)</p> Signup and view all the answers

    What might the nurse expect regarding serum phenytoin levels in a patient taking antacids for dyspepsia?

    <p>5 to 10 mcg/mL</p> Signup and view all the answers

    In a patient with new-onset dyspepsia after taking antacids, what action should the nurse take?

    <p>Obtain a serum phenytoin level.</p> Signup and view all the answers

    Which patient symptom indicates a potential side effect of phenytoin?

    <p>Reddish-brown urine.</p> Signup and view all the answers

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