What are the primary side effects provider should monitoring

Reference no: EM133716791

Problem

Allergies: NKDA

Demographic Data: 10-year-old, Caucasian male accompanied by 34-year-old biological mother Chief Complaint: "My son just doesn't listen to me."

History of Present Illness:

LG is a 10-year-old Caucasian male who presents with his mother to their pediatric nurse practitioner for LG's annual physical assessment prior to beginning 4th grade. The mother expresses concerns about LG's ongoing behavioral issues and reports that she had to enroll him in summer school and tutoring in an effort to avoid him being held back a year in school. She is anxious about the start of school, as he continues to have difficulties remaining seated for long periods of time. He is like an "energizer bunny- always on the go. He frequently starts tasks/homework, is unable to complete them, therefore she will finish them for him. Clearly frustrated, she states that she had to remind him five times to brush his teeth this morning and pick up his room before coming to this appointment. These symptoms are problematic all through the day until bedtime. He has always struggled to follow multi-step directions and he loses interest quickly in projects that require a lot of reading or writing.

Past Medical/Surgical History

Born premature at 35 weeks, tonsils removed at age 5. No cardiovascular, respiratory, or endocrine disorder history.
Past Psychiatric History

None documented; however, the school counselor recommended a psychological assessment after he struggled to complete the 3rd grade.

Family History

15-year-old male sibling- ADHD; 35-year-old biological father-Bipolar Disorder.

Social History

His mother reports that he can spend hours playing video games. He drinks two 24 oz Mountain Dew sodas daily, as his mom read online that it can be helpful to "control symptoms."

1) What would you start him on? Would you start LG on a stimulant medication? Why or why not? What are the risks and benefits? Which stimulant would you start first, why? Is there a different initial treatment you would recommend?

2) What are the primary side effects the provider should be monitoring for when starting a stimulant?

3) Which of LG's symptoms do you expect to show the most improvement early on in treatment?

4) Considering the frequent occurrence of co-existing conditions and LG's family history, what are some conditions and symptoms that you want to continue to monitor? How will you monitor and assess for these in your follow up appointments with LG?

Reference no: EM133716791

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