Author Question: A patient diagnosed with major depression began taking a tricyclic antidepressant 1 week ago. Today ... (Read 119 times)

penza

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A patient diagnosed with major depression began taking a tricyclic antidepressant 1 week ago. Today the patient says, I don't think I can keep taking these pills. They make me so dizzy, especially when I stand up. The nurse will:
 
  a. limit the patient's activities to those that can be performed in a sitting position.
  b. withhold the drug, force oral fluids, and notify the health care provider.
  c. teach the patient strategies to manage postural hypotension.
  d. update the patient's mental status examination.

Question 2

When counseling patients diagnosed with major depression, an advanced practice nurse will address the negative thought patterns by using:
 
  a. psychoanalytic therapy.
  b. desensitization therapy.
  c. cognitive behavioral therapy.
  d. alternative and complementary therapies.



dlook33

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Answer to Question 1

ANS: C
Drowsiness, dizziness, and postural hypotension usually subside after the first few weeks of therapy with tricyclic antidepressants. Postural hypotension can be managed by teaching the patient to stay well hydrated and rise slowly. Knowing this information may convince the patient to continue the medication. Activity is an important aspect of the patient's treatment plan and should not be limited to activities that can be done in a sitting position. Withholding the drug, forcing oral fluids, and notifying the health care provider are unnecessary actions. Independent nursing action is called for. Updating a mental status examination is unnecessary.

Answer to Question 2

ANS: C
Cognitive behavioral therapy attempts to alter the patient's dysfunctional beliefs by focusing on positive outcomes rather than negative attributions. The patient is also taught the connection between thoughts and resultant feelings. Research shows that cognitive behavioral therapy involves the formation of new connections between nerve cells in the brain and that it is at least as effective as medication. Evidence is not present to support superior outcomes for the other psychotherapeutic modalities mentioned.



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