A client who has been taking fluvoxamine (Luvox) without ...

[rmenurse]

A client who has been taking fluvoxamine (Luvox) without significant improvement asks a nurse, I heard about something called a monoamine oxidase inhibitor (MAOI).
 
  Can't my doctor add that to my medications? Which is an appropriate nursing reply? A. This combination of drugs can lead to delirium tremens.
  B. A combination of an MAOI and Luvox can lead to a life-threatening hypertensive crisis.
  C. That's a good idea. There have been good results with the combination of these two drugs.
  D. The only disadvantage would be the exorbitant cost of the MAOI.

Question 2

A confused client has recently been prescribed sertraline (Zoloft). The client's spouse is taking paroxetine (Paxil). The client presents with restlessness, tachycardia, diaphoresis, and tremors.
 
  What complication does a nurse suspect, and what could be its possible cause? A. Neuroleptic malignant syndrome caused by ingestion of two different serotonin reuptake inhibitors (SSRIs)
  B. Neuroleptic malignant syndrome caused by ingestion of an SSRI and a monoamine oxidase inhibitor (MAOI)
  C. Serotonin syndrome caused by ingestion of an SSRI and an MAOI
  D. Serotonin syndrome caused by ingestion of two different SSRIs

[raili21]

Answer to Question 1

B
The nurse should explain to the client that combining an MAOI and Luvox can lead to a life-threatening hypertensive crisis. Symptoms of hypertensive crisis include severe occipital and/or temporal pounding headaches with occasional photophobia, sensations of choking, palpitations, and a feeling of dread.

Answer to Question 2

D
The nurse should suspect that the client is suffering from serotonin syndrome possibly caused by ingesting two different SSRIs (Zoloft and Paxil). Symptoms of serotonin syndrome include confusion, agitation, tachycardia, hypertension, nausea, abdominal pain, myoclonus, muscle rigidity, fever, sweating, and tremor.

[rmenurse]

Excellent

[shailee]

TYSM