CH 22. Psychotherapeutic Agents (CNS Stimulants)

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."

What should the nurse's pre-administration assessment of a client receiving a CNS stimulant for respiratory depression include? (Select all that apply.)

Blood pressure

Pulse

Respiratory rate

Respiratory pattern

Review recent lab work

A nurse is providing care for a client diagnosed with attention deficit hyperactivity disorder (ADHD) who has been taking methylphenidate for several months. When monitoring for potential adverse effects, the nurse should include what assessments?

sleep patterns

A male client's health care provider orders antipsychotic medications for him. He experiences little or no side effects from the medications and is able to function successfully in both his home and work environments. Six weeks later, he is diagnosed with hepatitis B. He begins to experience adverse reactions to his medications. A possible reason for the adverse reactions might be that, in the presence of liver disease, what may happen?

Metabolism may be slowed and drug elimination half-lives prolonged, with resultant accumulation and increased risk of adverse effects.

A nurse is reviewing a bipolar client's serum lithium level, which is 1.8 mEq/L. What is the nurse's best action?

Inform the prescriber and monitor for GI and CNS effects

The nursing student is reviewing information learned in anatomy and physiology class about the nervous system. The student recalls that the nervous system has how many divisions?

2

A client is prescribed risperidone for the treatment of schizophrenia. The client is voiding three times each night and is always thirsty. Based on the adverse effects of risperidone, what should the nurse suspect is triggering the client’s reported polyuria and polydipsia?

Diabetes mellitus

A client, who has been diagnosed with schizophrenia and is taking an antipsychotic medication, reports constant thirst, frequent urination, and feeling nauseous. The nurse knows that the client may:

have undiagnosed diabetes.

A female client is diagnosed with renal insufficiency. The nurse develops a teaching plan based on the diagnosis and antipsychotic drug usage. The client asks the nurse why it is so important to have renal function tests routinely. The nurse replies that if renal function test results become abnormal, what may be a consequence?

The drug may need to be lowered in dosage or discontinued.

The nurse knows the medication methylphenidate is used to treat attention deficit hyperactivity disorder(ADHD). What type of medication is methylphenidate?

a central CNS stimulant

A child with attention deficit hyperactivity disorder has been receiving methylphenidate for several years. The prescriber has explained a plan to temporarily discontinue the drug. What rationale for this action should the nurse explain?

It needs to be determined if the child still has symptoms that require treatment.

The instructor is discussing psychosis with the nursing students. The instructor knows that teaching was effective when the students identify what behaviors are exhibited by people with psychosis?

Disorganized and often bizarre thinking

Serotonin abnormalities are thought to be involved in the following disorders:

Mental depression and sleep disorders.

What client is being treated with a typical antipsychotic?

An agitated client who was given haloperidol during acute psychosis

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).

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."

A nursing instructor is describing the effects of CNS stimulants and their potential for addiction due to their euphoric sensations. The instructor determines that the discussion was successful when the students identify which substance as being involved with this pleasurable feeling?

dopamine

The nurse in the emergency department admits a client that takes lithium for bipolar disorder. The client is experiencing seizures and is hypotensive. What does the nurse anticipate this client's lithium level will be?

3.1 mEq/L

The nurse is assessing an adolescent client diagnosed with attention deficit hyperactivity disorder (ADHD) for therapeutic effects of methylphenidate. The nurse should focus on improvement associated with what client functions? Select all that apply.

behavior

motor task performance

cognitive task performance

A client asks to have a year’s worth of prescription refills for methylphenidate, explaining that it is very hard to leave work for clinic appointments. How should the nurse respond to that request to best assure client safety?

"The prescription dose is always started as low as possible, and the refills are monitored to prevent abuse."

A nurse is teaching the client about CNS medications and how they are addictive. What is primary reason CNS medications are addictive?

A client is taking antipsychotic medication and asks the nurse what dopamine is. What is a correct response by the nurse?

"Dopamine is a neurotransmitter that deals with pleasure and reward in the brain."

Moderate CNS depression is characterized by:

Drowsiness or sleep; decreased muscle tone; decreased ability to move; and decreased perception of sensations such as pain, heat, and cold.