An adolescent female is brought to the emergency department after ...

[lb_gilbert]

An adolescent female is brought to the emergency department after experiencing a panic attack while at school.
 
  She had forgotten to study for a test in Biology. The mother indicates that her daughter is easily distracted, often forgets schoolwork, and has difficulty completing assignments and following instructions. She asks if her daughter should be on medication for ADHD. What is the nurse's best response?
  1. Many medications given for treatment of ADHD can worsen anxiety, which is a major component of panic attacks.
  2. Medication might help with the ADHD.
  3. Have you tried behavioral therapy for treatment of the ADHD?
  4. It is better to change the diet first as treatment for the ADHD.

Question 2

The nurse provides information regarding methylphenidate (Concerta) to the parents of a school-age client. Which statements indicate that the parents have good understanding of the information?
 
  Standard Text: Select all that apply.
  1. I will talk with the school nurse about administering a dose at about noon each day.
  2. We should fold the patch with the medication side facing in before it is thrown in the garbage.
  3. We should not expect physical dependence at the low dose given for ADHD.
  4. We can expect that the health care provider will occasionally tell us to stop giving the medication for a few days.
  5. If our child experiences loss of appetite, we should immediately contact the health care provider.

[Dnite]

Answer to Question 1

Correct Answer: 1
Rationale 1: Amphetamines and amphetamine-like medications are contraindicated in severe anxiety, as these medications can cause the anxiety to worsen.
Rationale 2: Medication might help is not the best answer, considering the effects of most ADHD medications on anxiety.
Rationale 3: Behavioral therapy might be beneficial, but this does not address the question asked.
Rationale 4: Changing the diet might be somewhat beneficial, but it does not address the question asked.
Global Rationale: Amphetamines and amphetamine-like medications are contraindicated in severe anxiety, as these medications can cause the anxiety to worsen. Medication might help is not the best answer, considering the effects of most ADHD medications on anxiety. Behavioral therapy might be beneficial, but this does not address the question asked. Changing the diet might be somewhat beneficial, but it does not address the question asked.

Answer to Question 2

Correct Answer: 3,4
Rationale 1: Concerta is a long duration form of methylphenidate. Midday dosing is not necessary.
Rationale 2: The patch form of methylphenidate is Daytrana, not Concerta.
Rationale 3: Physical dependence is uncommon at therapeutic dosages.
Rationale 4: The use of drug-free periods is common when therapy with Concerta is prolonged.
Rationale 5: Loss of appetite is a common adverse effect of Concerta. Notifying the health care provider is not necessary.
Global Rationale: Physical dependence is uncommon at therapeutic dosages. The use of drug-free periods is common when therapy with Concerta is prolonged. Concerta is a long duration form of methylphenidate. Midday dosing is not necessary. The patch form of methylphenidate is Daytrana, not Concerta. Loss of appetite is a common adverse effect of Concerta. Notifying the health care provider is not necessary.

[lb_gilbert]

Excellent

[ryhom]

TYSM