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
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 reports feelings of gloom and the inability to perform activities of daily living. The normal function of which neurotransmitter is most likely impaired?
Serotonin
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 black box warning alerts health care providers to risks in young adults 18 to 24 years of age when taking antidepressant medications. Which symptoms of concern should be included?
statements or resignation and futility and a desire to die
A client recently started on fluoxetine for the treatment of depression asks the nurse if there are any adverse effects to be aware of. The nurse should inform the client to be alert for what effects? Select all that apply.
anxiety insomnia nervousness
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
The nurse interviews the family of a client hospitalized with severe depression and suicidal ideations. What assessment data is important in planning this family's plan of care? (Select all that apply.)
Recent suicide attempts GI obstruction Affect
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.
A client on the psychiatry unit with a longstanding history of schizophrenia has been prescribed risperidone. What assessment should the nurse prioritize to best evaluate therapeutic effect of the treatment in the care of this client?
Assessment of the client's behaviors and thought processes
A client has recently received a diagnosis of depression and has been prescribed citalopram. The nurse is providing health education and the client states, "I'm relieved to have some medication to help with my mood, because it's my daughter's wedding next weekend and I'll be feeling better." What is the nurse's best response?
"Antidepressants will help your mood but it usually takes a few weeks to experience the benefits."
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 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 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
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 nurse is providing care on a psychiatric unit with many clients that take antidepressants. What client factor would the nurse have to consider when administering these medications?
A client has dysphagia
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
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.
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 client has been taking amitriptyline for the treatment of depression for several months. The client has been experiencing significant anticholinergic effects and has now presented to the emergency department reporting recent nausea, vomiting, dizziness and malaise. What assessment question should the nurse prioritize?
Are you still taking your medication consistently?"
The nurse is caring for a 32-year-old client who is taking amitriptyline for depression. What nursing intervention would be appropriate if this client developed orthostatic hypotension?
Asking the client to sit on the side of the bed for 1 minute before getting up
A client with a longstanding diagnosis of depression is being treated with phenelzine. The client reports the recent use of some over-the-counter flu and cold remedies and has consequently been admitted for observation and client teaching. What assessment should the nurse prioritize?
Blood pressure monitoring
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 nurse is caring for a patient with depression. Which symptom should the nurse closely monitor for in the patient?
Extreme sadness
Which agent would a nurse identify as a selective serotonin reuptake inhibitor?
Fluvoxamine
A client has been taking citalopram for 2 weeks and has expressed a desire to discontinue it, stating, "I don't feel any better than I did before I started these pills." What should the nurse teach the client?
It may take up to two more weeks before the client feels better
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.
Which antidepressant would the nurse identify as being one associated with the least amount of common adverse effects?
Nortriptyline
While reviewing the medication history of an older adult client, the nurse learns that the client is taking amitriptyline 25 mg three times per day. What adverse effect should the nurse prioritize when incorporating safety measures into the care plan?
Orthostatic hypotension
Which adverse effects would the nurse instruct a client to report to the health care provider immediately when taking trazodone?
Painful continued erection
A group of students are reviewing information about antidepressants that inhibit the activity of monoamine oxidase, leading to increase in epinephrine, norepinephrine, dopamine, and serotonin. The students demonstrate understanding when they identify which drug as acting in this manner?
Phenelzine
The nurse is aware that which medication taken by a client for treatment of mood disorder requires a diet that restricts the amount of tyramine eaten?
Phenelzine
A client has been taking a selective serotonin reuptake inhibitor (SSRI) for the treatment of depression. Which represents the action of the medication?
SSRIs prevent serotonin from being reabsorbed.
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.
A new mother asks her nurse about the safety of taking St. John's wort for postpartum depression. What would be the nurse's best response?
There is insufficient evidence to support the use of St. John's wort, and drug interactions may be extensive.
What is the major reason that monoamine oxidase inhibitors (MAOs) are rarely used in clinical practice today?
They may cause dangerous interactions with some foods and drugs.
Which medications exert their effects by inhibiting reuptake of norepinephrine and serotonin?
Tricyclic antidepressants
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
A client prescribed fluoxetine 1 week ago presents for a scheduled follow-up appointment. What should be the focus of the client's nursing assessment to best assure client safety?
presence of suicidal ideation