Exam (elaborations)
Nr606 Week 5 With Complete Solutions Latest Update
- Course
- NR606
- Institution
- Chamberlain College Of Nursing
Nr606 Week 5 With Complete Solutions Latest Update
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Solution 2024/2025Pepper
Nr606 Week 5 With Complete Solutions Latest
Update
Stimulant Medications: Methylphenidate ANS✔✔ -Low risk of adverse effects
-Available formulations:
• Ritalin - available in immediate release (IR) and extended release (XR)
available in beads that may be sprinkled on food for children who cannot
swallow pills
• Concerta biphasic - combined immediate and delayed release in one
medication
• Daytrana - patch applied in AM and removed after 9 hour
Stimulant Medications: Dexmethylphenidate (Focalin) ANS✔✔ -Available in
IR and ER
-More potent than Ritalin
-High risk of adverse effects
Stimulant Medications: Amphetamine (Adzenys) ANS✔✔ -available in orally
disintegrating ER formula for children who cannot swallow pills
-Avoid prescribing when an MAOI has been used within 14 days
Stimulant Medications: Dextroamphetamine (Adderall) ANS✔✔ -Available in
IR and extended-release formulations
-Often dosed in morning (IR or XR) with an evening or evening prn (IR) dose
if med effects diminish prior to end of school, study or the workday
-Most abused & diverted prescription stimulant
, Solution 2024/2025
Pepper
Stimulant Medications: Lisdexamfetamine (Vyvanse) ANS✔✔ -Biologically
inactive until metabolized by the body (Prodrug)
-Less abuse & diversion potential than other stimulants
-Higher-cost medication
Non-stimulant medication: Atomoxetine (Strattera) ANS✔✔ -Noradrenergic
(NRI)
-Initial drug of choice for adults with ADHD
-no abuse potential
-tolerated well when prescribed in BID dosing
-appropriate choice for comorbid substance abuse
-may augment the effects of antidepressants & antianxiety meds
-can be dosed at bedtime if fatigue is noted
-unlikely to worsen tics
Non-stimulant medication: Clonidine ANS✔✔ -α 2 agonist
• May be taken as monotherapy or with stimulant medications
-enhances precortical function for better mental focus
-appetite neutral
-may help with sleep disturbances, administer at bedtime
-adverse effects:
• sedation, brain fog
-monitor of BP closely during initial titration, risk of hypotension
-tapered to avoid rebound hypertension post discontinuation
, Solution 2024/2025
Pepper
Non-stimulant medication: guanfacine ANS✔✔ -α 2 agonist
• May be taken as monotherapy or with stimulant medications
-may also be used for children with tics, sleep disturbances, or aggression
-tolerability & convenience enhanced by once-daily oral controlled-release
formulation
-adverse effects:
• sedation, headache, decreased appetite
-reduced side-effect profile comparable to clonidine
-bedtime administration to avoid daytime sedation
Non-stimulant medication: Bupropion (Wellbutrin) ANS✔✔ -Norepinephrine
Dopamine Reuptake Inhibitor
-off-label use for ADHD in adults
-appropriate for clients with concurrent depression or tobacco abuse
Attention-deficit/hyperactivity disorder (ADHD) ANS✔✔ -one of the most
common neuropsychiatric disorders
-approximately 9.4% of children in the U.S.
-more frequently males than females, ratio 2:1
-symptom burden mild to severe
-characterized by consistent pattern of inattention &/or hyperactivity &
impulsivity that interferes with functioning & development
• affect development of proper cognitive, behavioral, emotional, social, &
academic function
, Solution 2024/2025
Pepper
-hyperactivity and impulsivity ADHD subtype symptoms: excessive fidgeting
or talking, feelings of restlessness and impatience, frequent interruption,
and difficultly playing quietly
-inattentive ADHD subtype symptoms: difficulty organizing tasks,
maintaining a routine, and paying attention to detail
• may not be distinguishable until eight or nine years of age
-primarily disrupts neuronal connections within the frontal lobe & prefrontal
cortex
Without early identification and proper treatment, ADHD can cause
disruptions in: ANS✔✔ academic performance
family stress
difficulties in social relationships
accidental injuries
ADHD is associated with: ANS✔✔ increased rates of depression & SUD
Symptoms of ADHD ANS✔✔ -Selective Attention
• Lack of attention to detail
• Careless mistakes
• Not listening
• Losing things
• Diverting attention
• Forgetfulness
-Lack of Sustained Attention
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