Therapeutic effects of methylphenidate. Case summary: N., is a 13 year old girl, diagnosed with an attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in the school orchestra. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

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Answer 1

Question

Chapter 13, Problem 1CS

(1)

Summary Introduction

To determine:

Therapeutic effects of methylphenidate.

Case summary:

N., is a 13 year old girl, diagnosed with an attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in the school orchestra. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

(2)

Summary Introduction

To determine:

Mother of N calls the physician and reports that N. is doing well in school, but her music band teacher reports that N gets restless during and after the rehearsals. She also informs that N is unable to sleep and staying awake for a long time at night. What should be the suggestions of a staff nurse involved?

Case summary:

N., is a 13 year old girl, diagnosed with an attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in the school orchestra. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

(3)

Summary Introduction

To determine:

At the end of two months check-up, the physician suggests N’s mother that ‘she can hold the drug during weekends and administer only on weekdays’ though N is at school. Height and weight measurements are taken, in addition. What is the reason for this “drug holiday” and the purpose of height and weight measurements?

Case summary:

N., is a 13 years old girl, diagnosed with attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in school band. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg two twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

(4)

Summary Introduction

To determine:

When it is time for a Ritalin refill, mother of N calls (on phone) the pharmacy. The pharmacist tells that he cannot refill this medication by phone and ask her to bring a new prescription for a refill. What is the reason for this?

Case summary:

N., is a 13 years old girl, diagnosed with attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in school band. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg two twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

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Considering the kcals the patient is receiving from propofol and D51⁄2NS, what should be the rate (ml/hr) of the tube feeding you selected? 30 ml/hr 45 ml/hr 55 ml/hr 65 ml/hr

You are seeing a 68 year-old male patient admitted to the ICU. He is sedated on the ventilator with propofol at 20ml/hr, D51⁄2NS running at 75ml/hr. and a past medical history of DM2, obesity, CAD, HTN, and Pneumonia. Ht 172cm, Wt 72kg, Alb 2.3, VE=7.9 L/min, Tmax =38.4 C 4.1 What is the total kcal this patient is receiving before the initiation of TF (Hint: include propofol and D51⁄2 NS in calculation)? 306 kcal 528 kcal 678 kcal 834 kcal What is the estimated kcal goal for this patient? 1787 kcal 1847 kcal 1927 kcal 2317 kcal What is the estimated protein need for this patient? 45 – 50 g/day 86 – 108g/day 108 – 180g/day 144 – 188 g/day What type of tube feeding formula would you recommend for this patient? Standard 1.5 kcal/ml formula Glycemic control product, 1.0 kcal/ml Low residue, high protein, nutritionally balanced,1.2 kcal/ml High protein, calorie control product, 2.0 kcal/ml

You are seeing a 68 year-old male patient admitted to the ICU. He is sedated on the ventilator with propofol at 20ml/hr, D51⁄2NS running at 75ml/hr. and a past medical history of DM2, obesity, CAD, HTN, and Pneumonia. Ht 172cm, Wt 72kg, Alb 2.3, VE=7.9 L/min, Tmax =38.4 C 4.1 What is the total kcal this patient is receiving before the initiation of TF (Hint: include propofol and D51⁄2 NS in calculation)? 306 kcal 528 kcal 678 kcal 834 kcal Which estimated prediction equation will you recommend to calculate the kcal need for this patient? Penn State Equation (2003b): Mifflin(0.96)+ VE (31) + Tmax (167)-6212 MifflinStJeor =(10xW)+(6.25xHt)–(5xAge)+5 Harris-Benedict equation: kcal/day (male) = 66 +13.8 (W) + 5.0(H) – (6.8 x A) Ireton-Jones equations (1992)(ventilator-dependent): 1925 – 10 (A) + 5 (W) + 281 (S) + 292 (T) + 851 (B) What is the estimated kcal goal for this patient? 1787 kcal 1847 kcal 1927 kcal 2317 kcal What is the…

Answer 2

Question

Chapter 13, Problem 1CS

(1)

Summary Introduction

To determine:

Therapeutic effects of methylphenidate.

Case summary:

N., is a 13 year old girl, diagnosed with an attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in the school orchestra. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

(2)

Summary Introduction

To determine:

Mother of N calls the physician and reports that N. is doing well in school, but her music band teacher reports that N gets restless during and after the rehearsals. She also informs that N is unable to sleep and staying awake for a long time at night. What should be the suggestions of a staff nurse involved?

Case summary:

N., is a 13 year old girl, diagnosed with an attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in the school orchestra. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

(3)

Summary Introduction

To determine:

At the end of two months check-up, the physician suggests N’s mother that ‘she can hold the drug during weekends and administer only on weekdays’ though N is at school. Height and weight measurements are taken, in addition. What is the reason for this “drug holiday” and the purpose of height and weight measurements?

Case summary:

N., is a 13 years old girl, diagnosed with attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in school band. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg two twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

(4)

Summary Introduction

To determine:

When it is time for a Ritalin refill, mother of N calls (on phone) the pharmacy. The pharmacist tells that he cannot refill this medication by phone and ask her to bring a new prescription for a refill. What is the reason for this?

Case summary:

N., is a 13 years old girl, diagnosed with attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in school band. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg two twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

Expert Solution & Answer

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Check out a sample textbook solution

See solution

Answer 3

Question

Chapter 13, Problem 1CS

(1)

Summary Introduction

To determine:

Therapeutic effects of methylphenidate.

Case summary:

N., is a 13 year old girl, diagnosed with an attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in the school orchestra. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

(2)

Summary Introduction

To determine:

Mother of N calls the physician and reports that N. is doing well in school, but her music band teacher reports that N gets restless during and after the rehearsals. She also informs that N is unable to sleep and staying awake for a long time at night. What should be the suggestions of a staff nurse involved?

Case summary:

N., is a 13 year old girl, diagnosed with an attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in the school orchestra. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

(3)

Summary Introduction

To determine:

At the end of two months check-up, the physician suggests N’s mother that ‘she can hold the drug during weekends and administer only on weekdays’ though N is at school. Height and weight measurements are taken, in addition. What is the reason for this “drug holiday” and the purpose of height and weight measurements?

Case summary:

N., is a 13 years old girl, diagnosed with attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in school band. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg two twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

(4)

Summary Introduction

To determine:

When it is time for a Ritalin refill, mother of N calls (on phone) the pharmacy. The pharmacist tells that he cannot refill this medication by phone and ask her to bring a new prescription for a refill. What is the reason for this?

Case summary:

N., is a 13 years old girl, diagnosed with attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in school band. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg two twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

Expert Solution & Answer

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Check out a sample textbook solution

See solution

Answer 4

Question

Chapter 13, Problem 1CS

(1)

Summary Introduction

To determine:

Therapeutic effects of methylphenidate.

Case summary:

N., is a 13 year old girl, diagnosed with an attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in the school orchestra. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

(2)

Summary Introduction

To determine:

Mother of N calls the physician and reports that N. is doing well in school, but her music band teacher reports that N gets restless during and after the rehearsals. She also informs that N is unable to sleep and staying awake for a long time at night. What should be the suggestions of a staff nurse involved?

Case summary:

N., is a 13 year old girl, diagnosed with an attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in the school orchestra. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

(3)

Summary Introduction

To determine:

At the end of two months check-up, the physician suggests N’s mother that ‘she can hold the drug during weekends and administer only on weekdays’ though N is at school. Height and weight measurements are taken, in addition. What is the reason for this “drug holiday” and the purpose of height and weight measurements?

Case summary:

N., is a 13 years old girl, diagnosed with attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in school band. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg two twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

(4)

Summary Introduction

To determine:

When it is time for a Ritalin refill, mother of N calls (on phone) the pharmacy. The pharmacist tells that he cannot refill this medication by phone and ask her to bring a new prescription for a refill. What is the reason for this?

Case summary:

N., is a 13 years old girl, diagnosed with attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in school band. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg two twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

Expert Solution & Answer

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Check out a sample textbook solution

See solution

Answer 5

Chapter 13, Problem 1CS

(1)

Summary Introduction

To determine:

Therapeutic effects of methylphenidate.

Case summary:

N., is a 13 year old girl, diagnosed with an attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in the school orchestra. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

(2)

Summary Introduction

To determine:

Mother of N calls the physician and reports that N. is doing well in school, but her music band teacher reports that N gets restless during and after the rehearsals. She also informs that N is unable to sleep and staying awake for a long time at night. What should be the suggestions of a staff nurse involved?

Case summary:

N., is a 13 year old girl, diagnosed with an attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in the school orchestra. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

(3)

Summary Introduction

To determine:

At the end of two months check-up, the physician suggests N’s mother that ‘she can hold the drug during weekends and administer only on weekdays’ though N is at school. Height and weight measurements are taken, in addition. What is the reason for this “drug holiday” and the purpose of height and weight measurements?

Case summary:

N., is a 13 years old girl, diagnosed with attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in school band. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg two twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

(4)

Summary Introduction

To determine:

When it is time for a Ritalin refill, mother of N calls (on phone) the pharmacy. The pharmacist tells that he cannot refill this medication by phone and ask her to bring a new prescription for a refill. What is the reason for this?

Case summary:

N., is a 13 years old girl, diagnosed with attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in school band. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg two twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

Answer 6

Chapter 13, Problem 1CS

(1)

Summary Introduction

To determine:

Therapeutic effects of methylphenidate.

Case summary:

N., is a 13 year old girl, diagnosed with an attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in the school orchestra. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

Answer 7

Chapter 13, Problem 1CS

(1)

Summary Introduction

To determine:

Therapeutic effects of methylphenidate.

Case summary:

N., is a 13 year old girl, diagnosed with an attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in the school orchestra. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

Answer 8

(2)

Summary Introduction

To determine:

Mother of N calls the physician and reports that N. is doing well in school, but her music band teacher reports that N gets restless during and after the rehearsals. She also informs that N is unable to sleep and staying awake for a long time at night. What should be the suggestions of a staff nurse involved?

Case summary:

N., is a 13 year old girl, diagnosed with an attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in the school orchestra. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

Answer 9

(2)

Summary Introduction

To determine:

Mother of N calls the physician and reports that N. is doing well in school, but her music band teacher reports that N gets restless during and after the rehearsals. She also informs that N is unable to sleep and staying awake for a long time at night. What should be the suggestions of a staff nurse involved?

Case summary:

N., is a 13 year old girl, diagnosed with an attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in the school orchestra. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

Answer 10

(3)

Summary Introduction

To determine:

At the end of two months check-up, the physician suggests N’s mother that ‘she can hold the drug during weekends and administer only on weekdays’ though N is at school. Height and weight measurements are taken, in addition. What is the reason for this “drug holiday” and the purpose of height and weight measurements?

Case summary:

N., is a 13 years old girl, diagnosed with attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in school band. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg two twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

Answer 11

(3)

Summary Introduction

To determine:

At the end of two months check-up, the physician suggests N’s mother that ‘she can hold the drug during weekends and administer only on weekdays’ though N is at school. Height and weight measurements are taken, in addition. What is the reason for this “drug holiday” and the purpose of height and weight measurements?

Case summary:

N., is a 13 years old girl, diagnosed with attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in school band. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg two twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

Answer 12

(4)

Summary Introduction

To determine:

When it is time for a Ritalin refill, mother of N calls (on phone) the pharmacy. The pharmacist tells that he cannot refill this medication by phone and ask her to bring a new prescription for a refill. What is the reason for this?

Case summary:

N., is a 13 years old girl, diagnosed with attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in school band. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg two twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

Answer 13

(4)

Summary Introduction

To determine:

When it is time for a Ritalin refill, mother of N calls (on phone) the pharmacy. The pharmacist tells that he cannot refill this medication by phone and ask her to bring a new prescription for a refill. What is the reason for this?

Case summary:

N., is a 13 years old girl, diagnosed with attention deficit hypersentivity disorder (ADHD). She is studying in seventh grade and a clarinet player in school band. Her parents noticed that she had trouble in focusing on music and assignments for the past one year. Her parents have discussed about her problems with her paediatrician. He has prescribed methylphenidate (Ritalin) 5 mg two twice daily for two weeks by increasing the dose to 10 mg daily if no improvements were observed.

Answer 14

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Answer 15

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Answer 16

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Answer 17

Ch. 13 - Prob. 1O Ch. 13 - Prob. 2O Ch. 13 - Prob. 3O Ch. 13 - Prob. 4O Ch. 13 - Prob. 5O Ch. 13 - Prob. 1CS Ch. 13 - Prob. 1NERQ Ch. 13 - Prob. 2NERQ Ch. 13 - Prob. 3NERQ Ch. 13 - Prob. 4NERQ

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