# 一位護理師正在指導一名8歲孩童的父母，該孩童剛被開立哌醋甲酯速釋劑型用於治療注意力不足過動症。下列哪一項護理指導最為重要？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391735&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

一位護理師正在指導一名8歲孩童的父母，該孩童剛被開立哌醋甲酯速釋劑型用於治療注意力不足過動症。下列哪一項護理指導最為重要？

## 選項

1. 規劃在週末和假期期間安排一個不用藥的時期，以減少副作用。
2. 如果兒童在週末看起來比平常更過動，則增加劑量。
3. 第二劑應在下午早些時候、下午4點前給予，以避免失眠。 **✔ 正確答案**
4. 兩次劑量都與高脂肪餐一起服用，以提高吸收和效果。

**正確答案: 3**

## 解析

正確 (2)：哌醋甲酯為中樞神經興奮劑；下午或傍晚服藥會導致失眠。標準作法是早上及午後早期服藥（速釋劑型通常在中午前及下午2至4點前服用）。(1) 食物不會顯著影響速釋劑型；重點在於服藥時間，而非吸收。(3) 父母不可自行調整劑量；生長、食慾、血壓及心率需由開藥醫師監測。(4) 例行性藥物假期已不再是標準作法——應與開藥醫師個別化決定，而非由父母主動執行。

## 深入解析

Memory Tip: Stimulants reduce appetite and sleep.

## 臨床情境

Scenario 8-year-old boy starting methylphenidate IR 5 mg PO BID for ADHD.

## 重要概念

- **CNS stimulant** — Drug class first-line for ADHD.
- **ADHD monitoring** — Routine tracking of weight, height, BP, HR, sleep, appetite.
- **Drug holiday** — Planned medication-free period.

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