While the nurse is performing a physical assessment, the patient ...

[cartlidgeashley]

While the nurse is performing a physical assessment, the patient begins to cry and states, I just can't seem to be happy. I thought the reserpine I was prescribed would help my chronic depression and my high blood pressure.
 
  Which of the following is the best nursing response to the patient?
  a. Explain to the patient that the medication is not indicated for depression; depression is actually a side effect of the medication. The patient should speak to the prescriber about alternative medications.
  b. Reassure the patient that the medication takes about 3 weeks for full effectiveness to treat both hypertension and depression.
  c. Explain to the patient that the depression will last only a few days.
  d. Have a psychiatric consult ordered.

Question 2

A nurse is making a home visit to a patient just discharged from the hospital. The patient states, I've just started taking clonidine (Catapres), but it's making me so drowsy.
 
  Select the nurse's most appropriate response to the patient regarding this concern.
  a. Discontinue the medication, and contact your prescriber.
  b. Are you taking this medication for pain or high blood pressure?
  c. Drowsiness is very common early in therapy, but the effects will lessen with time.
  d. Are you having any blurred vision?

[josephsuarez]

Answer to Question 1

ANS: A
Reserpine can produce severe depression, which may persist for months during drug therapy and after the drug is withdrawn. Reserpine is not used to treat chronic depression, therefore the patient should speak to the prescriber about alternative medications to treat hypertension and chronic depression.
Reassuring the patient does not address the depression, which this medication does not treat. Depression is a side effect of this medication. The patient should speak to the prescriber about alternative medications.
Depression is a side effect of reserpine, and there is no time frame for how long the depression might last.
A psychiatric consult is not warranted at this time. The patient needs to speak to the prescriber about alternative medications that address both chronic depression and hypertension.

Answer to Question 2

ANS: C
Central nervous system depression, evidenced in this patient by drowsiness, is common in about 35 of the population. These responses become less intense with continued drug use.
The patient should not discontinue the medication abruptly because of the potential for rebound hypertension. The patient should contact the prescriber prior to stopping the medication.
The nurse should be aware of the reason the patient is taking the medication; also, this response disregards the patient's concern about drowsiness.
Blurred vision is not a side effect of clonidine and therefore not relevant.