Author Question: A 75-year-old patient with a long history of depression begins amitriptyline (Elavil) 100 mg/day. ... (Read 144 times)

nramada · **on:** Jul 19, 2018

A 75-year-old patient with a long history of depression begins amitriptyline (Elavil) 100 mg/day. The patient also takes a diuretic daily for hypertension. The highest priority nursing diagnosis is risk for

a. falls related to dizziness and orthostatic hypotension.
b. ineffective thermoregulation related to anhidrosis.
c. infection related to suppressed white blood cell count.
d. constipation related to slowed peristalsis.

Question 2

A patient with depression has taken an SSRI for 1 month. The nurse should use direct questions to evaluate which potential side effect?

a. Aggressive impulses
b. Sexual dysfunction
c. Paranoid delusions
d. Weight gain

owenfalvey · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

A
Amitriptyline is a TCA that has a high risk of producing orthostatic hypotension. The patient is placed at even greater risk because of older age and diuretic therapy, which reduces fluid volume. The other options are either unassociated or are remote possibilities.

Answer to Question 2

B
SSRIs often produce sexual dysfunction, such as decreased libido. Patients readily tell nurses about anticholinergic, gastrointestinal, and other side effects, but are not as forthcoming in reporting sexual problems. The nurse might need to ask directly to elicit this information. Patients are more willing to discuss the other options.