A nurse is assessing a patient with major depressive disorder (MDD). Which assessment tool can the nurse use to measure the severity and impact of depression on the patient’s functioning?

Choice C rationale:

The nurse should emphasize the importance of reporting any side effects to the healthcare provider when educating a patient with MDD who has been prescribed an atypical antidepressant. Side effects can vary from person to person, and prompt reporting allows the healthcare provider to monitor and manage any adverse reactions effectively.

Choice A Rationale:

Choice A (Taking the medication only as needed) is incorrect because atypical antidepressants, like other antidepressants, need to be taken consistently as prescribed. Taking them as needed may not provide the sustained therapeutic levels required to manage MDD effectively.

Choice B Rationale:

Choice B (Taking the medication on an empty stomach) is not a key aspect of medication adherence for atypical antidepressants. While some medications do require administration on an empty stomach, this is not a general guideline for all antidepressants.

Choice D Rationale:

Choice D (Stopping the medication abruptly if side effects occur) is incorrect. Abruptly stopping an antidepressant, including atypical ones, can lead to withdrawal symptoms and a sudden return of depressive symptoms. Discontinuation should be done under the guidance of a healthcare professional and usually involves tapering the dose.

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Choice A rationale:

Dairy products, in general, do not have a significant interaction with TCAs (Tricyclic Antidepressants). The concern with dairy products is usually related to their interaction with certain antibiotics. Therefore, avoiding dairy products is not necessary for someone taking TCAs.

Choice B rationale:

Fresh fruits do not have a notable interaction with TCAs. In fact, a diet rich in fresh fruits can be beneficial for overall health. There is no need to advise avoiding fresh fruits due to TCA use.

Choice C rationale:

(Correct Choice) Aged cheese should be avoided when taking TCAs. Aged cheeses, such as cheddar, blue cheese, and parmesan, contain tyramine, which can lead to a hypertensive crisis when consumed along with TCAs. This interaction is a result of the monoamine oxidase inhibitory effects of TCAs, which can lead to elevated levels of tyramine in the bloodstream.

Choice D rationale:

Leafy vegetables do not have a significant interaction with TCAs. Leafy vegetables are generally considered healthy and are not contraindicated when taking these medications. Therefore, there is no need for the client to avoid leafy vegetables due to TCA use.