A client being seen in the mental health clinic is being started ...

[serike]

A client being seen in the mental health clinic is being started on tricyclic antidepressants for treatment of depression. Which condition in the client's history should be brought to the attention of the primary care provider?
 
  1. The client smokes cigarettes.
  2. The client was unresponsive to treatment with selective serotonin reuptake inhibitors (SSRIs).
  3. The client has a history of previous suicide attempts.
  4. The client lives alone.

Question 2

A client being treated for depression with a selective serotonin reuptake inhibitor (SSRI) becomes agitated and diaphoretic and complains of muscle spasms and tremors.
 
  The client's sister confides to the nurse that her sister has been taking Saint John's wort daily for the last 6 months. Which action should be taken by the nurse?
 
  1. Ask the client to give the Saint John's wort tablets to the staff.
  2. Discuss the dangers of taking over-the-counter herbal preparations with the client.
  3. Withhold any scheduled doses of the SSRI and notify the physician.
  4. Have the laboratory draw blood work for a serotonin level.

[mceravolo]

Answer to Question 1

Answer: 3

1. Smoking would not be significant.
2. Tricyclic antidepressants are sometimes effective for people unresponsive to other antidepressants.
3. Tricyclic antidepressants can be fatal if an overdose is taken; clients sometimes take the medications to commit suicide.
4. Living alone would not be significant.

Answer to Question 2

Answer: 3

1. This does not address the critical nature of the situation.
2. This does not address the critical nature of the situation.
3. The symptoms are suggestive of serotonin syndrome as a result of excess serotonin activity from the Saint John's wort and SSRI. It can be fatal, and needs to be reported immediately.
4. This does not address the critical nature of the situation.

[serike]

Thanks for the timely response, appreciate it

[kthug]

Excellent