An elderly client has met the criteria for a diagnosis of major ...

[frankwu]

An elderly client has met the criteria for a diagnosis of major depressive disorder. The client does not respond to antidepressant medications. Which treatment should a nurse anticipate that the physician would prescribe for this client?
 
  A. Electroconvulsive therapy (ECT)
  B. Neuroleptic therapy
  C. An antiparkinsonian agent
  D. An anxiolytic agent

Question 2

An elderly client is exhibiting symptoms of major depressive disorder. A physician is considering prescribing an antidepressant. Which physiological problem should make a nurse question this medication regimen?
 
  A. Altered cortical and intellectual functioning
  B. Altered respiratory and gastrointestinal functioning
  C. Altered liver and kidney functioning
  D. Altered endocrine and immune system functioning

[Fayaz00962]

Answer to Question 1

A
The nurse should anticipate that ECT will be ordered to treat this client's symptoms of depression. ECT remains one of the safest and most effective treatments for major depressive disorder in older adults. When a client does not respond to antidepressant medications or has been diagnosed with co-morbid disease processes that prohibit the use of antidepressant medications, ECT is considered the treatment of choice. The response to ECT may be slower in older clients, and the effects may be of limited duration.

Answer to Question 2

C
The nurse should question the use of an antidepressant medication in a client with altered liver and kidney function. Antidepressant medication should be administered with consideration for age-related physiological changes in absorption, distribution, elimination, and brain receptor sensitivity. Because of these changes, medications can reach high levels despite moderate oral dosage.