Chapter 15: Antidepressant Drugs; Questions
& Answers 100% Solved
Priority assessments for a patient beginning amitriptyline (Elavil) include:
a.
nausea, diarrhea, and irritability.
b.
seizures, agranulocytosis, and insomnia.
c.
headache, sexual dysfunction, and weight loss.
d.
orthostat...
Chapter 15: Antidepressant Drugs; Questions
& Answers 100% Solved
Priority assessments for a patient beginning amitriptyline (Elavil) include:
a.
nausea, diarrhea, and irritability.
b.
seizures, agranulocytosis, and insomnia.
c.
headache, sexual dysfunction, and weight loss.
d.
orthostatic hypotension, arrhythmias, and eye pain. Correct answer-ANS: D
Tricyclic antidepressants (TCAs) produce anticholinergic (eye pain) and antiadrenergic
(orthostatic hypotension and arrhythmias) side effects. GI symptoms, sexual dysfunction, and
weight variations are related to selective serotonin reuptake inhibitor (SSRI) therapy. Seizures
are seen with Wellbutrin therapy. Agranulocytosis is not considered a major problem with any
of the groups of antidepressants.
A 75-year-old patient with a long history of depression begins amitryptiline (Elavil) 100 mg/day.
The patient also takes a diuretic daily for hypertension. The highest priority nursing diagnosis is
risk for:
a.
falls related to dizziness and orthostatic hypotension.
b.
ineffective thermoregulation related to anhidrosis.
constipation related to slowed peristalsis. Correct answer-ANS: A
Amitryptiline is a TCA that has a high risk of producing orthostatic hypotension. The patient is
placed at even greater risk because of older age and diuretic therapy, which reduces fluid
volume. The other options are either unassociated or are remote possibilities.
A depressed patient prepares for discharge. The patient will take desipramine (Norpramin) and
have outpatient visits. The patient complains, "They gave me only a one-week supply of my
medicine." Select the nurse's best reply.
a.
"Federal law limits the amount you may be given at any one time."
b.
"It will save you money if the drug doesn't work well for your symptoms."
c.
"This is a way of ensuring that you will come in for your follow-up appointment."
d.
"Prescribing a small amount of drug addresses our concerns for your continuing safety."
Correct answer-ANS: D
Desipramine is an activating antidepressant, and it might provide a patient who has suicidal
ideation with the energy to make an attempt. Because the therapeutic dose and lethal dose are
, Chapter 15: Antidepressant Drugs; Questions
& Answers 100% Solved
not widely separated, TCA overdose is an often used suicide plan. Prescribing only a 7-day
supply limits the possibility of using the drug in a suicide attempt. The other options are either
less relevant or incorrect.
Evaluation of a patient's response after one week of tricyclic antidepressant therapy would be
expected to show:
a.
no change in objective or subjective symptoms.
b.
increased appetite and weight gain.
c.
decreased suicidal ideation.
d.
improved mood and affect. Correct answer-ANS: B
Improved appetite might be caused by the antihistaminic effect of the drug. Improvement in
mood might not occur for 2 to 4 weeks. Suicidal ideation might not improve for 2 to 4 weeks.
A patient with depression and vague suicidal ideation will stay at home, have close family
supervision, and make weekly visits to the health care provider. Bupropion (Wellbutrin) is
prescribed. What is the benefit of bupropion in this scenario?
a.
It has antianxiety properties as well as antidepressant effects.
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