A client was prescribed escitalopram (Lexapro) for treatment of ...

[abarnes]

A client was prescribed escitalopram (Lexapro) for treatment of obsessive-compulsive disorder. Unknown to the nurse, the client has also been self-medicating with St. John's wort.
 
  The client comes to the office with symptoms of hyperthermia and diaphoresis. Which statement best describes the result of the nurse's assessment? 1. The client has not been taking escitalopram (Lexapro) and is experiencing withdrawal.
   2. The client has combined two antidepressant medications and is experiencing serotonin syndrome.
   3. The client is experiencing symptoms of St. John's wort toxicity, as the medication was most likely outdated.
   4. The client has contracted a viral infection. Escitalopram (Lexapro) and St. John's wort are safe to take together.

Question 2

When you cannot rely on the spoken word to document a client's pain, you need to use behavioral characteristics instead. These include which of the following?
 
  1. intensity of the client's reaction to pain
  2. client's self-evaluation
  3. restlessness or agitation in a comatose client or crying in a neonate
  4. crying in a comatose or neonate client

[Sarahjh]

Answer to Question 1

2. The client has combined two antidepressant medications and is experiencing serotonin syndrome.

Rationale:
Use caution with herbal supplements such as St. John's wort, which may increase the effects of escitalopram (Lexapro) and cause serotonin syndrome. The client's symptoms are consistent with serotonin syndrome, and there is no evidence that the client has not been taking the escitalopram (Lexapro) or that the St. John's wort is outdated. It is not considered safe to combine escitalopram (Lexapro) and St. John's wort.

Answer to Question 2

ANS: 3