prep u anti depressant drugs
The health care provider would not prescribe duloxetine (Cymbalta) for a client with a mood disorder if the client took which other medication?
A medication for hypertension
The psychiatric-mental health nurse is overseeing care of several clients who are being treated with selective serotonin reuptake inhibitors. Which client should the nurse monitor most closely for adverse effects?
A severely depressed 14-year-old client who is receiving inpatient care
The client has been perscribed 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
What drug should the nurse consider contraindicated for the client taking a monoamine oxidase inhibitor (MAOI)?
Escitalopram (Lexapro)
The nurse is caring for a young female client who is 5 weeks pregnant. What statement made by the nurse about the use of antidepressants during pregnancy is most accurate?
"Antidepressants are used very cautiously during pregnancy and only when benefit outweighs risk."
An adult client, diagnosed with depression several weeks ago, has begun taking citalopram 10 days ago. The client has told the nurse of the intent to stop taking the drug, stating, "I don't feel any less depressed than I did before I started taking these pills." How should the nurse best respond to the client's statement?
"I'd encourage you to continue with the drug; it can take several weeks before it improves your mood."
A client has been taking fluoxetine (Prozac) for the last ten days. Today the client the clinic 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."
An adult client has been diagnosed and the client's psychiatrist has prescribed amitriptyline 100 mg PO daily. What education should the nurse provide about this drug regimen?
"Many people find this drug makes them drowsy, so it's best to take it at bedtime." "If you find that you have a dry mouth, try sucking on lozenges or hard candies." "It's possible that you might have a bit of difficulty starting your urine stream." "Let your psychiatrist know promptly if you have any changes in your vision."
The client has been admitted to the behavioral health unit. The nursing diagnosis iis "Risk for Suicide". Which statement by the client supports this nursing diagnosis?
"Now that this depression is lifting, I know exactly what I need to do.
A client has been taking Prozac for the past two months for depression. She is seeing her gynecologist for premenopausal symptoms and during the interview with the nurse she says, "I'm interested in trying Sarafem because my friend is taking it and she says it works great." What is the best response by the nurse?
"Sarafem and Prozac are different brand names for the same generic medication."
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 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 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."
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
For which client would the black box warning that is present on all antidepressants be most relevant?
A 12 year-old boy who has been diagnosed with depression by a pediatric psychiatrist
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 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 while experiencing depression is reluctant to start on antidepressant medication. What information should be the basis for the nurse's best response?
Antidepressant therapy may be indicated if depressive symptoms impair social relationships or work performance and occur independently of life events.
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 nurse is preparing to administer an antidepressant that affects the neurotransmission of norepinephrine, serotonin, and dopamine. Which drug would the nurse be most likely to administer?
Bupropion
A nurse is preparing to administer selective serotonin reuptake inhibitors (SSRIs) to a group of clients. The nurse would administer the drug cautiously to which clients?
Clients with diabetes mellitus
A client is receiving a tricyclic antidepressant for treatment of obsessive-compulsive disorder. Which agent most likely would be prescribed?
Clomipramine
The nurse in a long-term care facility is providing care for an 83-year-old client who has depression and who has been prescribed clomipramine. The client has twice reported urinary hesitation since starting this treatment and required intermittent urinary catheterization overnight to relieve bladder distention. What is the nurse's best action?
Contact the care provider promptly to advocate for a change in the medication regimen.
A nurse instructs a client that the effects of which drug, if prescribed, can be decreased with cigarette smoking?
Fluoxetine
Which agent would a nurse identify as a selective serotonin reuptake inhibitor?
Fluvoxamine
A client has been prescribed a monoamine oxidase inhibitor (MAOI) by the health care provider. Before administration of the drug, the client wants to know about possible adverse reactions. Which would the nurse expect to describe?
Hypertensive crisis
The nurse is admitting a client who has a possible diagnosis of mood disorder. The nurse assesses the client for symptoms of what medical condition that may be mistaken for a mood disorder
Hypothyroidism
A 11-year-old client has been hospitalized with severe depression. For the past several weeks, the client has been prescribed a selective serotonin reuptake inhibitor (SSRI). What is the priority nursing action?
Implement suicide precautions.
An older adult was diagnosed with depression several decades and has been taking tricyclic antidepressants (TCAs) ever since, with good effect. The nurse should recognize what therapeutic action of this client's medication?
Inhibiting reuptake of norepinephrine and serotonin
The client has been depressed since her father died 6 months ago. The client's healthcare provider has prescribed amitriptyline. What aspect of this client's health history should prompt the nurse to contact the prescriber?
Ischemic heart disease
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.
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 comes to the mental health clinic for a regular appointment. The client tells the nurse he has been taking oral fluoxetine 20 mg daily for the past 3 weeks and that he has lost 3 pounds during that time due to a loss of appetite. What action should the nurse take?
Reassuring the client that this is a common adverse effect with this medication
A middle-aged client was diagnosed with major depression after a suicide attempt several months ago and has failed to respond appreciably to treatment with SSRIs. As a result, the client was prescribed phenelzine. When planning this client's subsequent care, what nursing diagnosis should the nurse prioritize?
Risk for Injury related to drug-drug interactions or drug-nutrient interactions
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 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.
The is a 35-year-old diagnosed two weeks ago with depression. What is a realistic goal of antidepressant therapy
To bring about the greatest relief of symptoms while minimizing unpleasant adverse effects as much as possible
Which medications exert their effects by inhibiting reuptake of norepinephrine and serotonin?
Tricyclic antidepressants
Which food should the client avoid eating when prescribed phenelzine sulfate?
aged Swiss cheese and bratwurst
What statement should a nurse use to plan a client assessment for the characterizations associated with major depression?
an impaired ability to function in activities and relationships
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.
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
What adverse effect could be related to a fall experienced by an older client prescribed amitriptyline?
orthostatic hypotension
A client has been prescribed a tricyclic antidepressant. What subsequent adverse effects of this drug should the nurse discuss with the client? Select all that apply.
urinary retention blurred vision dry mouth
