After 6 months of taking imipramine (Tofranil) for depressive ...

[jayhills49]

After 6 months of taking imipramine (Tofranil) for depressive symptoms, a client complains that the medication doesn't seem as effective as before. Which question should the nurse ask to determine the cause of this problem?
 
  1. Are you consuming foods high in tyramine?
  2. How many packs of cigarettes do you smoke daily?
  3. Do you drink any alcohol?
  4. Are you taking St. John's wort?

Question 2

A physically healthy, 35-year-old, single client lives with parents, who provide total financial support. According to Erikson's theory, which developmental task should a nurse assist the client to accomplish?
 
  1. Establishing the ability to control emotional reactions2. Establishing a strong sense of ethics and character structure3. Establishing and maintaining self-esteem 4. Establishing a career, personal relationships, and societal connections

[nekcihc358]

Answer to Question 1

2
Rationale: Imipramine is a tricyclic antidepressant. Smoking should be avoided while receiving tricyclic therapy. Smoking increases the metabolism of tricyclics, requiring an adjustment in dosage to achieve the therapeutic effect. Alcohol potentiates the effects of antidepressants. Tyramine is only an issue when MAOI medications are prescribed. Concomitant use of St. John's wort and SSRIs, not tricyclics, increases, not decreases the effects of the drug.

Answer to Question 2

4
Rationale: The nurse should assist the client in establishing a career, personal relationships, and societal connections. According to Erikson, nonachievement of the generativity versus stagnation stage results in self-absorption, including withdrawal from others and having no capacity for giving of the self to others.

[jayhills49]

TYSM

[bulacsom]

Thanks for the timely response, appreciate it