A patient has been taking an SSRI antidepressant for major ...

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A patient has been taking an SSRI antidepressant for major depression and reports having headaches and jaw pain. What will the nurse tell the patient?
 
  a. This represents an irreversible extrapyra-midal side effect.
  b. Discuss discontinuing the antidepressant with the provider.
  c. Discuss these symptoms with a dentist.
  d. Try stress-relieving methods and relaxa-tion techniques.

Question 2

A postmenopausal patient who has had a hysterectomy and who has a family history of coronary heart disease reports experiencing vaginal dryness and pain with intercourse but tells the nurse that she doesn't want to take hormones because she is
 
  afraid of adverse effects. The nurse will suggest that the woman ask her provider about: a. Depo Provera.
  b. Estraderm.
  c. low-dose estrogens.
  d. Premarin vaginal.

[chjcharjto14]

Answer to Question 1

C
Bruxism is a side effect of SSRIs and can result in headache and jaw pain. Patients who expe-rience these signs should be evaluated for bruxism by a dentist, who can determine whether the patient may benefit from use of a mouth guard. Headache and jaw pain are not signs of extrapy-ramidal side effects. Discontinuing the antidepressant is not indicated, because depression may return. Stress-relieving methods and relaxation techniques are not recommended, because these symptoms occur during sleep.

Answer to Question 2

D
Estrogens for intravaginal administration are used for local effects, primarily to treat vulval and vaginal atrophy. Because these preparations bypass the liver, the total dose is reduced and there is a lower risk of systemic effects. Depo Provera is a progesterone and is not indicated. Trans-dermal estrogen is used to treat hot flushes. Low-dose estrogens still have systemic effects.

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