A client is prescribed duloxetine (Cymbalta) for fibromyalgia. ...

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A client is prescribed duloxetine (Cymbalta) for fibromyalgia. When teaching the client about this medication, the nurse will include which adverse or side effects?
 
  Standard Text: Select all that apply.
  1. Constipation is an adverse effect.
  2. Weight loss can occur when taking this medication.
  3. Headaches are an adverse effect.
  4. An increase in sexual desire may occur.
  5. Symptoms of social anxiety disorder may decrease while taking this medication.

Question 2

A client with anxiety reports difficulty sleeping and waking up several times throughout the night. The nurse is concerned that the client can develop imbalances in which neurotransmitters?
 
  Standard Text: Select all that apply.
  1. Acetylcholine
  2. Serotonin
  3. Norepinephrine
  4. Dopamine
  5. Gamma-aminobutyric acid

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Answer to Question 1

Correct Answer: 1,2,3
Rationale 1: Constipation is an adverse effect of this medication.
Rationale 2: Weight loss is an adverse effect of this medication.
Rationale 3: Headaches are adverse effects of this medication.
Rationale 4: This medication does not cause an increase in sexual desire.
Rationale 5: This medication reduces the symptoms of general anxiety disorder, not social anxiety disorder.
Global Rationale: Constipation, weight loss, and headaches are adverse effects of this medication. This medication does not cause an increase in sexual desire. This medication reduces the symptoms of general anxiety disorder, not social anxiety disorder.

Answer to Question 2

Correct Answer: 1,2,3
Rationale 1: When moving from non-REM to REM sleep, there is an increase of acetylcholine. If either sleep stage is interrupted, an imbalance in the amount of acetylcholine could occur.
Rationale 2: In REM sleep, the body increases the levels of serotonin. In the absence of REM sleep, an imbalance in the amount of serotonin may occur.
Rationale 3: In REM sleep, the body increases the levels of norepinephrine. In the absence of REM sleep, an imbalance in the amount of norepinephrine may occur.
Rationale 4: Dopamine is not impacted by the amount of non-REM or REM sleep.
Rationale 5: Gamma-aminobutyric acid is not impacted by the amount of non-REM or REM sleep.
Global Rationale: When moving from non-REM to REM sleep, there is an increase of acetylcholine. If either sleep stage is interrupted, an imbalance in the amount of acetylcholine could occur. In REM sleep, the body increases the levels of serotonin and norepinephrine. In the absence of REM sleep, an imbalance in the amount of serotonin and norepinephrine may occur. Dopamine and gamma-aminobutyric acid is not impacted by the amount of non-REM or REM sleep.

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