A patient being treated for depression has taken 300 mg ...

[Capo]

A patient being treated for depression has taken 300 mg amitriptyline (Elavil) daily for a year. The patient calls the case manager at the clinic and says, I stopped taking my antidepressant 2 days ago.
 
  Now I am having cold sweats, nausea, a rapid heartbeat, and nightmares. The nurse will advise the patient to:
 
  a. Go to the nearest emergency department immediately.
  b. Do not to be alarmed. Take two aspirin and drink plenty of fluids.
  c. Take a dose of your antidepressant now and come to the clinic to see the health care provider.
  d. Resume taking your antidepressants for 2 more weeks and then discontinue them again.

Question 2

Which documentation for a patient diagnosed with major depression indicates the treatment plan was effective?
 
  a. Slept 6 hours uninterrupted. Sang with activity group. Anticipates seeing grandchild.
  b. Slept 10 hours uninterrupted. Attended craft group; stated project was a failure, just like me.
  c. Slept 5 hours with brief interruptions. Personal hygiene adequate with assistance. Weight loss of 1 pound.
  d. Slept 7 hours uninterrupted. Preoccupied with perceived inadequacies. States, I feel tired all the time.

[snackralk]

Answer to Question 1

ANS: C
The patient has symptoms associated with abrupt withdrawal of the tricyclic antidepressant. Taking a dose of the drug will ameliorate the symptoms. Seeing the health care provider will allow the patient to discuss the advisability of going off the medication and to be given a gradual withdrawal schedule if discontinuation is the decision. This situation is not a medical emergency, although it calls for medical advice. Resuming taking the antidepressant for 2 more weeks and then discontinuing again would produce the same symptoms the patient is experiencing.

Answer to Question 2

ANS: A
Sleeping 6 hours, participating with a group, and anticipating an event are all positive events. All the other options show at least one negative finding.