Greene is an 85-year-old male placed on a 5150 by the crisis team after his nurse called them. He has taken a fall in his driveway after his dialysis. He has end-stage kidney disease, diabetes, and a history of myocardial infarction 4 years ago. He was living alone until his home health nurse found him crying out in pain, clutching onto his leg in the kitchen. “I’m so tired,” he says.
Nortriptyline and some tricyclic antidepressants may be helpful with neuropathic pain but are often contraindicated in elderly clients such as Mr. Greene because (select the best answer)
Are outdated medications
Can increase cardiac side effects and urinary retention
Are only taken at night
Are expensive
Are expensive
The Correct Answer is B
Choice A reason:
While some may consider tricyclic antidepressants outdated, they are still used for certain conditions, including neuropathic pain. The primary concern with their use in elderly clients is not their age but their side effect profile.
Choice B reason:
Tricyclic antidepressants, including nortriptyline, can increase cardiac side effects and urinary retention, which are significant concerns in elderly clients. These medications can cause orthostatic hypotension, arrhythmias, and exacerbate urinary retention, making them less suitable for older adults with pre-existing health conditions.
Choice C reason:
The timing of medication administration (e.g., only taken at night) is not the primary issue with tricyclic antidepressants. The concern lies in their side effects, which can be particularly problematic for elderly clients.
Choice D reason:
While the cost of medication can be a factor in treatment decisions, it is not the primary reason tricyclic antidepressants are contraindicated in elderly clients. The main concern is their potential to cause serious side effects.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
Anger is one of the stages of grief according to Kubler-Ross. Edward’s statement about wanting to punch his aunt reflects feelings of frustration and anger, which are common during this stage. Anger can be directed at various targets, including loved ones, healthcare providers, or even the deceased.
Choice B reason:
Denial is the initial stage of grief where individuals may refuse to accept the reality of the loss. Edward’s statement does not indicate denial but rather an active expression of anger and frustration.
Choice C reason:
Acceptance is the final stage of grief where individuals come to terms with the loss. Edward’s statement indicates unresolved anger, suggesting that he has not yet reached the stage of acceptance.
Choice D reason:
Bargaining involves making deals or promises in an attempt to reverse or lessen the loss. Edward’s statement does not reflect bargaining but rather anger towards his aunt for not informing him sooner.
Correct Answer is ["A","C","D"]
Explanation
Choice A reason:
Hopelessness with poor concentration is a common symptom of major depression. Individuals with depression often feel a pervasive sense of hopelessness and find it difficult to concentrate on tasks or make decisions.
Choice B reason:
Increased energy is not a typical symptom of major depression. In fact, individuals with depression often experience fatigue and a lack of energy. Increased energy may be more indicative of a manic episode in bipolar disorder.
Choice C reason:
Difficulty falling asleep and early morning awakening are common symptoms of major depression. Sleep disturbances, including insomnia and early morning awakening, are frequently reported by individuals with depression.
Choice D reason:
Anhedonia, or the loss of interest or pleasure in previously enjoyed activities, is a hallmark symptom of major depression. Individuals with depression often find it difficult to experience joy or satisfaction in activities they once found pleasurable.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.