Chapter 21: Antidepressant Agents

A client has been prescribed phenelzine sulfate. When providing teaching, which food should the nurse instruct the client to avoid eating?

Salami

Following a thorough health history and assessment, a client's health care provider has diagnosed the client with depression. The nurse should anticipate that the client will likely be prescribed what classification of antidepressant?

Selective serotonin reuptake inhibitor

After teaching a group of nursing students about antidepressants, the instructor determines that the teaching was successful when the students identify which as inhibiting the reuptake of serotonin?

Selective serotonin reuptake inhibitors

A client who was previously taking paroxetine is being switched to phenelzine due to a lack of response. The nurse would expect that the phenelzine will be started at which time?

Several weeks after stopping the paroxetine

A 30-year-old client is taking phenelzine 30mg PO tid. The nurse knows that at that dosage, the client will need to be carefully monitored for which?

dizziness.

A client with a severe depression has been hospitalized, and the health care provider has ordered amitriptyline. What common adverse effect might this client have?

dry mouth

A 12-year-old client who has been taking sertraline for the past 2 weeks has returned to the clinic to be seen. It will be critical for the nurse to assess for which?

onset of suicidal ideation.

A nurse is working with a client who is taking an MAOI. What would be the most important instruction to the client?

avoid use of soy sauce in the diet

To best assure client safety, what information should the nurse provide to a client whose fluoxetine therapy has been discontinued?

The dosage of the medication will be gradually reduced over a period of 6 to 8 weeks.

The nurse is reviewing a new client's current medication regimen, which includes a ten-week course of bupropion 150 mg PO b.i.d. The nurse has assessed the client for any history of depression, which the client denies. What assessment question should the nurse ask next?

"Are you in the process of quitting smoking?"

A physician has prescribed an antidepressant medication for a 15-year-old client. Which statement would be appropriate for inclusion in medication teaching?

"There may be an increased risk of suicide while taking this drug."

What instructions should a nurse include when teaching a client who has depression about the use of amitriptyline?

"Use sugarless hard candies and gum to deal with dry mouth."

A community health nurse follows many clients, several of whom have depression and who are taking antidepressants. What assessment finding should the nurse prioritize for reporting to the care provider?

A client who began taking escitalopram two weeks ago says her mood has worsened since starting the drug

A client is prescribed transdermal selegiline. What health education should the nurse provide?

"Place the patch on dry skin on your torso that has no cuts or openings."

A client has been diagnosed with depression. The provider has ordered sertraline. The client asks, "How soon will it be until I feel better?" What would be the best response by the nurse?

"The medication will start to work in about 10 days, but it may take up to 4 weeks to be fully effective."

A client with depression has been taking citalopram for several months and has presented for a follow-up assessment. The client tells the nurse, "I've been reading a lot online about the benefits of St. John's wort for depression, so I've started taking it once per day." In addition to referring the client to the provider, what is the nurse's best response?

"There can be an unsafe reaction between your antidepressant and St. John's wort, which is why taking them both is discouraged."

A client is receiving an SSRI. The nurse would inform the client that the full benefits of the drug may not occur for which time period?

4 weeks

The nurse at an outpatient mental health unit is reviewing the black box warning that applies to clients who are taking antidepressants. To which of the nurse's clients would the black box warning apply?

A 14 year-old client who has been diagnosed with major depression

Several clients are prescribed sertraline therapy on the unit. Which client would require the closest monitoring by the nurse?

A 45-year-old man with liver impairment

A male client has a history of hepatic dysfunction secondary to alcoholism. Based on the client's diagnostic history, what would the nurse expect his health care provider to order?

A lower dose of the antidepressant

The client has been prescribed an MAO inhibitor. As the nurse teaches the client about this medication, what foods will the client be instructed to avoid?

Aged cheeses and meats, concentrated yeast extracts, sauerkraut, and fava beans

Venlafaxine is an antidepressant that has become more popular with adults in treating their depression. Why has it become more popular?

An extended release form is available.

A client prescribed a selective serotonin reuptake inhibitor has begun taking St. John's wort daily. The nurse should teach the client that this combination may result in what adverse reaction?

Dangerous drug interactions

Which agent would a nurse identify as a selective serotonin reuptake inhibitor?

Fluvoxamine

An 8-year-old client has been diagnosed with enuresis. What medication does the nurse suspect the health care provider will prescribe?

Imipramine

A tricyclic antidepressant has been prescribed to a 77-year-old client whose current medication regimen includes omeprazole, captopril, calcium carbonate, alendronate, and warfarin. What assessment should the nurse prioritize when monitoring the client for drug-drug interactions?

Monitor the client closely for bleeding and review coagulation indices when available.

The nurse is assessing a 13-year-old client who has symptoms of depression and recognizes that what class of antidepressant medication would not be a drug of choice for an adolescent?

TCAs

A female client has been diagnosed with depression. She also has a history of alcoholism. She has been sober now for 4 months, but at her last physical examination, the health care provider noted right-upper-quadrant tenderness and elevated liver enzyme levels. The provider has prescribed sertraline to treat the client's depression. Which factor would need to be considered prior to administering this medication?

The medication should be started at a lower dose due to liver dysfunction, and the client should be monitored for side effects.

Why are selective serotonin reuptake inhibitors considered the first line of drug therapy for patients with depression?

The medications have fewer anticholinergic effects than alternatives

A nurse is caring for a patient who has been prescribed a monoamine oxidase inhibitor (MAOI). What should the nurse ask the patient to avoid?

Yogurt

What adverse effect could be related to a fall experienced by an older client prescribed amitriptyline?

orthostatic hypotension