A client with postpartum depression receives a prescription for sertraline. Which information is most important for the nurse to include in client teaching?
Contact the healthcare provider (HCP) immediately if suicidal thoughts occur.
Contact the healthcare provider (HCP) immediately if muscle stiffness occurs.
Increase activity level to include a daily exercise routine.
Avoid processed meats, red wine, and Swiss cheese.
The Correct Answer is A
A. Contact the healthcare provider (HCP) immediately if suicidal thoughts occur: Antidepressants like sertraline can increase the risk of suicidal thoughts, especially during the early stages of treatment. Immediate reporting of such thoughts is critical to ensure the client’s safety and prevent harm.
B. Contact the healthcare provider (HCP) immediately if muscle stiffness occurs: Although rare, muscle stiffness could signal serotonin syndrome if occurs with a constellation of symptoms including confusion, agitation, fever, sweating and tremors, not just stiffness. Suicidal ideation presents a more immediate and life-threatening risk in clients starting antidepressants and requires the highest priority.
C. Increase activity level to include a daily exercise routine: While exercise is beneficial for managing depression, it is supportive therapy and not the most urgent teaching point compared to recognizing and reporting suicidal ideation associated with antidepressant use.
D. Avoid processed meats, red wine, and Swiss cheese: This dietary restriction is necessary when taking monoamine oxidase inhibitors (MAOIs) to prevent hypertensive crises. Sertraline is a selective serotonin reuptake inhibitor (SSRI), so these dietary precautions are not required.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Determine what time the dose is taken: Dextroamphetamine-amphetamine is a stimulant that can interfere with sleep if taken too late in the day. The timing of the dose is crucial because early morning dosing minimizes insomnia, making this the most important initial assessment.
B. Ask about the client's bedtime routine: While bedtime routines can influence sleep quality, stimulant medication timing has a much stronger direct effect on insomnia, making this a secondary consideration after reviewing dose timing.
C. Inquire about perceived anxiety: Anxiety can contribute to sleep difficulties, but in clients taking stimulants, medication effects are a more likely cause. Addressing medication-related factors takes priority over psychological causes in this case.
D. Determine daily caffeine intake: Caffeine may worsen insomnia, but stimulant medications are generally a stronger factor in causing sleep disturbances. Assessing caffeine use is important but not the first priority compared to reviewing medication timing.
Correct Answer is D
Explanation
A. Use relaxation techniques to reduce excessive anxiety: Incorporating non-pharmacological strategies such as relaxation exercises complements lorazepam therapy and can improve anxiety management. This statement reflects appropriate understanding and safe self-care practices.
B. Avoid alcohol and other sedatives while taking the medication: Lorazepam is a central nervous system depressant, and combining it with alcohol or other sedatives can lead to respiratory depression, increased sedation, and potentially life-threatening effects. This is an important and accurate precaution.
C. Move slowly from a sitting position to a standing position: Orthostatic hypotension and dizziness are common side effects of benzodiazepines like lorazepam. Changing positions slowly helps minimize the risk of falls, especially in older adults or those sensitive to the medication.
D. Stop taking the medication if intended effect is not immediate: Lorazepam has a relatively quick onset, but stopping it abruptly without consulting a healthcare provider is unsafe and may lead to withdrawal symptoms including increased anxiety, insomnia, tremors, and even seizures. Clients must understand that medication adjustments require medical guidance.
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