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Exhibits

The nurse evaluates the client and begins preparing for her discharge.

Choose the most likely options for the information missing from the statements by selecting from the lists provided.

The nurse teaches the client that it will take

for the sertraline to reach full therapeutic effect and explains the client has been set up to receive and reprocessing as an outpatient. The nurse also teaches the client to complement the medication and therapy.
Answer and Explanation

The Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"C","dropdown-group-3":"B"}

Rationale for Correct Choices

  • 4 to 8 weeks: Sertraline, an SSRI, typically requires 4 to 8 weeks to reach its full therapeutic effect. This time frame allows for sufficient serotonin modulation, necessary for symptom improvement in conditions like PTSD and depression.
  • Eye movement desensitization: Eye Movement Desensitization and Reprocessing (EMDR) is specifically recommended for PTSD. It involves guided eye movements that help the brain reprocess traumatic events and reduce emotional disturbance.
  • Deep breathing: Deep breathing promotes parasympathetic nervous system activation, helping reduce anxiety and hyperarousal. It is a simple, accessible coping strategy to complement therapy and medication.

Rationale for Incorrect Choices

  • 1 to 2 days: This timeframe is too short for an SSRI to have significant therapeutic effects. Any changes in mood or anxiety within this period are typically not due to the medication’s primary mechanism of action.
  • 10 to 14 days: Although some mild improvement may begin, full therapeutic benefits of sertraline are not typically seen within this period. Clients are advised to continue consistent use for several weeks.
  • Cognitive behavioural therapy: CBT is effective for many mental health disorders, including PTSD, but it does not involve the “reprocessing” component referenced.
  • Prolonged exposure therapy: Prolonged exposure is used for PTSD treatment but focuses on gradually confronting trauma-related memories. It lacks the reprocessing element emphasized in the question.
  • Progressive muscle relaxation: While useful for anxiety reduction, it is more complex and less immediate than deep breathing. It also requires a quiet space and more time, which may limit spontaneous use.
  • Guided imagery: Guided imagery can reduce anxiety but involves visualization, which may not be suitable for individuals with intrusive trauma-related images. Deep breathing is simpler and more universally applicable.


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Related Questions

Correct Answer is C

Explanation

Rationale:
A. Teach parents about poison prevention in young children: While this is an important long-term intervention, it does not address the immediate concern of replacing a potentially lost therapeutic dose of the antidote. Teaching should occur after the child’s safety is ensured.

B. Lavage activated charcoal before giving acetylcysteine dose: Activated charcoal may reduce acetylcysteine’s effectiveness when administered together. Gastric lavage is not routinely indicated if the child is alert and beyond the immediate ingestion window, and is not a substitute for re-dosing the antidote.

C. If dose is vomited within 1 hour of administration, repeat that oral dose: Re-administering N-acetylcysteine within one hour of vomiting ensures the child receives an effective therapeutic dose. Prompt re-dosing is crucial in preventing hepatic damage.

D. Obtain blood samples to monitor liver function: Liver function tests are part of ongoing monitoring but do not address the acute need to ensure the antidote is absorbed. Blood work is secondary to ensuring that the child receives the full therapeutic dose.

Correct Answer is B

Explanation

Rationale:

A. Limit intake of fatty foods for one month after surgery: While dietary modifications are beneficial for overall liver health, avoiding fatty foods is not the top priority post-transplant. The client’s greatest risk in the early period is infection due to immunosuppressive therapy.

B. Avoid crowds for first two months after surgery: Immunosuppressive medications increase the client’s susceptibility to infections. Avoiding crowds reduces exposure to viruses and bacteria, making this the most critical instruction for early post-transplant safety.

C. Notify the healthcare provider if edema occurs: Edema may signal fluid imbalance or graft dysfunction and should be reported, but it is a secondary concern compared to preventing infection, which can rapidly become life-threatening in immunocompromised individuals.

D. Increase activity and exercise gradually, as tolerated: Gradual resumption of physical activity is important for recovery, but it should be balanced with the need to prevent infection. Infection prevention remains the most urgent teaching point.

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