Pharm: Chapter 22: Antidepressant Drugs

After teaching a client who is prescribed lithium about the drug, the nurse determines that the teaching was successful when the client states which of the following?

"I should take the drug with food."

A client is prescribed lithium. The nurse suspects lithium toxicity based on which lithium drug level?

1.6 mEq/L

When monitoring a patient receiving escitalopram for therapeutic effectiveness, the nurse would keep in mind that full effect may take up to how long?

4 weeks

When taking MAO inhibitors, clients should avoid which of the following foods?

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

Your client informs you that he has been struggling with depression; however, he does not know if it is severe enough to start on medication. Your best response would be:

Antidepressant therapy may be indicated if depressive symptoms persist at least 2 weeks, impair social relationships or work performance, and occur independently of life events.

A client is receiving lithium therapy at a health care facility. The client informs the nurse that he is taking antacids for heartburn. The nurse would be alert for which of the following due to the interaction of the two drugs?

Decreased effectiveness of lithium

When assessing a client for depression, which of the following would the nurse most likely find?

Extreme sadness

A patient who ingests foods high in tyramine while taking a selective serotonin reuptake inhibitor is at risk for developing severe hypertensive crisis.

False

When developing the plan of care for a client who is receiving lithium therapy, which nursing diagnosis would the nurse most likely identify as a priority?

Imbalanced Fluid Volume

A client is prescribed a monoamine oxidase inhibitor (MAOI) for depression. During the initial interview with the client, the nurse understands that the client is also receiving an adrenergic agent. The nurse would be alert for which of the following?

Increased risk for cardiac arrhythmias

A nurse is caring for a client with suicidal tendencies. Which of the following would be most important for the nurse to do after administering the drug orally?

Inspect the oral cavity to ensure that the drug is swallowed.

A nurse is caring for an older adult client who has been prescribed amoxapine for depression accompanied by anxiety. After administration of the drug, the nurse observes muscle rigidity and sweating. The nurse identifies these as the symptoms of neuroleptic malignant syndrome. Which of the following would the nurse do next?

Stop the drug and contact the physician.

MAO inhibitors are rarely used in clinical practice today, mainly because:

They may interact with some foods and drugs to produce severe hypertension and possible heart attack.

Which of the following class of antidepressants exert their effects by inhibiting reuptake of norepinephrine and serotonin? (Choose one)

Tricyclic antidepressant

Anticholinergic effects such as dry mouth, sedation, and urinary retention are common adverse events occurring with the use of which of the following classes of antidepressants? (Choose one)

Tricyclic antidepressants

A nurse is caring for a client who has been prescribed a monoamine oxidase inhibitor (MAOI). Which of the following should the nurse instruct the client to avoid?

Yogurt

A client is prescribed phenelzine. Which of the following would the nurse instruct the client to avoid? Select all that apply

• Blue cheese • Pepperoni • Chocolate

A nurse administers amitriptyline cautiously to which clients? Select all that apply.

• Clients with cardiac disease • Elderly clients

A nurse understands that duloxetine may be used to treat which of the following? Select all that apply.

• Depression • Diabetic neuropathy • Fibromyalgia • Stress incontinence

A nurse understands that the antidepressant drug paroxetine (Paxil) can be used to treat which of the following medical conditions? Select all that apply.

• Depressive episodes • Obsessive-compulsive disorders • Bulimia nervosa

The nurse suspects that a client is experiencing major depression based on assessment of which of the following? Select all that apply.

• Excessive guilt • Loss of energy • Feelings of hopelessness

Which of the following would the nurse report to the primary health care provider if assessed in a client receiving an antidepressant? Select all that apply.

• Expressions of guilt • Indirect threats of suicide • Insomnia

Which of the following antidepressants exert their effects by inhibiting the reuptake of serotonin? Select all that apply.

• Fluoxetine • Escitalopram

Antidepressants can often have GI adverse reactions that can result in a nursing diagnosis of Imbalanced Nutrition: Less Than Body Requirements. Which of the following would be appropriate for the nurse to suggest to minimize these effects? Select all that apply.

• Increase fiber intake. • Increase fluid intake. • Chew sugarless gum.

A client is prescribed paroxetine. When teaching the client about this drug, which of the following would the nurse include as a possible adverse reaction? Select all that apply.

• Insomnia • Diarrhea • Somnolence • Sexual dysfunction • Constipation

Before administering an antidepressant to a client, which of the following would the nurse assess? Select all that apply.

• Mental status • Weight • Complete medical history • Presence of suicidal ideation • Vital signs

When describing the action of antidepressants, the nursing instructor would include the belief that they exert their effect by causing slow adaptive changes to which of the following receptor systems? Select all that apply.

• Norepinephrine • Serotonin

A nurse caring for a client taking amitriptyline for depression should monitor the client for which of the following adverse events? Select all that apply.

• Sedation • Photosensitivity • Dry mouth

After teaching a group of students about antidepressant therapy, the instructor determines that the teaching was successful when the students identify which of the following as a class of antidepressants? Select all that apply.

• Selective serotonin reuptake inhibitors • Tricyclics • Monoamine oxidase inhibitors

A client taking phenelzine (Nardil) is at a dinner party and has several glasses of red wine. The client begins to feel nauseated and develops a terrible headache. The client is taken to the nearest emergency department (ED). This client might be experiencing a hypertensive crisis. What other symptoms might the nurse in the ED assess if the client is experiencing a hypertensive crisis? Select all that apply.

• Tachycardia • Stiff neck • Chest pain