Which client comment would alert the nurse that atomoxetine ...

[jc611]

Which client comment would alert the nurse that atomoxetine (Strattera) should be held and the health care provider notified?
 
  1. I get lightheaded when I get out of bed in the mornings.
  2. Sometimes I have difficulty going to sleep.
  3. I always feel like I have such a dry mouth.
  4. Sometimes I feel like I'd be better off if I were dead.

Question 2

A school-age client who is taking amphetamine sulfate (Adderall) for treatment of ADHD is seen in the clinic for routine follow-up. The nurse will automatically perform which functions?
 
  Standard Text: Select all that apply.
  1. Measure the client's height and weight.
  2. Assess vital signs, especially heart rate and BP.
  3. Obtain labs to assess cardiovascular status.
  4. Obtain a fasting blood glucose.
  5. Instruct the parent and child on how to obtain a 24-hour urine collection for proteinuria.

[heinisk01]

Answer to Question 1

Correct Answer: 4
Rationale 1: Orthostatic hypotension is a side effect of Strattera. The client should get up slowly from lying to sitting and then sitting to standing to allow for adjustment in change of position.
Rationale 2: Insomnia is a common side effect of medications given to treat ADHD. It is not the most important issue.
Rationale 3: A dry mouth can be treated with increased fluid intake and sugarless gum or hard candy.
Rationale 4: Suicidal ideation is a serious adverse effect of Strattera. The medication should be held, and the health care provider notified immediately.
Global Rationale: Suicidal ideation is a serious adverse effect of Strattera. The medication should be held, and the health care provider notified immediately. Orthostatic hypotension is a side effect of Strattera. The client should get up slowly from lying to sitting and then sitting to standing to allow for adjustment in change of position. Insomnia is a common side effect of medications given to treat ADHD. It is not the most important issue. A dry mouth can be treated with increased fluid intake and sugarless gum or hard candy.

Answer to Question 2

Correct Answer: 1,2
Rationale 1: Placing children on amphetamines for ADHD can stunt their growth. Height and weight should be checked regularly.
Rationale 2: Amphetamines can increase BP and heart rate. Both should be monitored.
Rationale 3: A cardiovascular workup is to be performed prior to starting amphetamines. There is nothing in the stem to indicate further workup is necessary at this time.
Rationale 4: There is no evidence that the client is having symptoms of blood glucose imbalance.
Rationale 5: There is no reason to perform a 24-hour urine, as there is no indication that the client is experiencing renal problems.
Global Rationale: Placing children on amphetamines for ADHD can stunt their growth. Height and weight should be checked regularly. Amphetamines can increase BP and heart rate. Both should be monitored. A cardiovascular workup is to be performed prior to starting amphetamines. There is nothing in the stem to indicate further workup is necessary at this time. There is no evidence that the client is having symptoms of blood glucose imbalance. There is no reason to perform a 24-hour urine, as there is no indication that the client is experiencing renal problems.