A patient tells the nurse, My doctor prescribed Paxil ...

[vHAUNG6011]

A patient tells the nurse, My doctor prescribed Paxil (paroxetine) for my depression. I assume I'll have side effects like I had when I was taking Tofranil (imipramine).
 
  The nurse's reply should be based on the knowledge that paroxetine is a:
  a. selective norepinephrine reuptake inhibitor.
  b. tricyclic antidepressant.
  c. MAO inhibitor.
  d. SSRI.

Question 2

When working with a patient with posttraumatic stress disorder who has frequent flashbacks as well as persistent symptoms of arousal, effective nursing interventions would include:
 
  a. encouraging repression of memories associated with the traumatic event.
  b. explaining that physical symptoms are related to the psychological state.
  c. triggering flashbacks as a way to help the patient learn to cope with them.
  d. supporting numbing as a temporary way to manage intolerable feelings.

[AaaA]

Answer to Question 1

A
Paroxetine is an SSRI and will not produce the same side effects as imipramine, a tricyclic antidepressant. The patient will probably not experience dry mouth, constipation, or orthostatic hypotension.

Answer to Question 2

B
Persons with posttraumatic stress disorder often experience somatic symptoms or sympathetic nervous system arousal that can be confusing and distressing. Explaining that these are the body's responses to psychological trauma helps the patient understand how such symptoms are part of the illness and something that will respond to treatment. This decreases powerlessness over the symptoms and helps instill a sense of hope, reinforcing his participation in treatment. It also helps the patient to understand how relaxation, breathing exercises, and imagery can be helpful in symptom reduction. The goal of treatment for posttraumatic stress disorder is to come to terms with the event rather than repress it, so repression of memories and use of numbing are targeted for reduction rather than promoted. Triggering flashbacks would increase patient distress and is not necessary to recovery.