The adolescent has been diagnosed with Attention Deficit ...

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The adolescent has been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and is taking methylphenidate (Ritalin).
 
  Even though the drug helps with focus and grades, the adolescent will not go to the school office at noon for his medication. Which statement best describes the result of the nurse's evaluation? 1. The adolescent really does not need an additional dose of methylphenidate (Ritalin) at school.
   2. The adolescent has developed alternative coping mechanisms to increase his focus during classes.
   3. The adolescent is fearful that this drug may be a gateway drug and he will abuse other substances.
   4. The adolescent is embarrassed about having to take medicine at school; it is a social stigma.

Question 2

Which of the following should the nurse instruct a client who is starting to take metoprolol?
 
  1. Expect a rapid heart rate
   2. Weigh daily
   3. Increase fluids
   4. Reduce protein intake

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Answer to Question 1

4. The adolescent is embarrassed about having to take medicine at school; it is a social stigma.

Rationale:
Some clients believe that having to take drugs in school will cause them to be viewed as weak, unhealthy, or dependent. Clients can also perceive this as a social stigma. Methylphenidate (Ritalin) is a short-acting drug and doses must be administered about four hours apart, so the client must receive a dose during school hours. ADHD is a brain-based disorder, and the primary treatment is medication; alternative coping mechanisms will not usually help to increase focus during classes. Appropriate treatment of ADHD will result in less of the likelihood for addiction to mood-altering substances, not more addiction.

Answer to Question 2

2. Weigh daily

Rationale:
The client being prescribed metoprolol should be instructed to weigh self daily to assess for fluid retention. This medication does not cause a rapid heart rate. The client should not be instructed to increase fluids. Protein restriction is not indicated with this medication.

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Excellent

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