Chapter 21 Antidepressant Agents

A nurse educating a client starting phenelzine should educate the client to avoid which foods? (Select all that apply.)

blue cheese pepperoni chocolate

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

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 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?

four weeks

The nurse would assess for what in a client with type 2 diabetes using an oral antidiabetic agent and receiving an MAOI?

hypoglycemia

The nurse is caring for a client taking fluoxetine for depression. Which assessment findings indicate that the medication is effective? Select all that apply.

improved sleep decreased anxiety interest in physical activity

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 resignations and futility and a desire to die

A client with depression began taking fluoxetine 10 days ago. The nurse should monitor the client for what adverse effect?

anorexia

After failing to respond to treatment with SSRIs and tricyclic antidepressants, a client with major depression has been started on phenelzine. The client's current drug regimen also includes levothyroxine, metformin and simvastatin. What assessment should the nurse prioritize when monitoring for drug-drug interactions?

assessing the client's blood glucose levels frequently

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 patient is receiving an antidepressant that helps to decrease addictive behavior. Which drug most likely would be prescribed?

Venlafaxine

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."

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 has been taking fluoxetine (Prozac) for the last ten days. Today the client is reporting not feeling any better. What is the nurse's best response to this client?

"It may take another two to three weeks before the medication is completely 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."

How long does a patient need to wait after stopping a phenelzine before starting paroxetine?

14 days

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 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.

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.

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

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

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

salami

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

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.