Author Question: A patient taking amitriptyline (Elavil) complains of having blurred vision and dry mouth, and he ... (Read 105 times)

xroflmao · **on:** Jul 23, 2018

A patient taking amitriptyline (Elavil) complains of having blurred vision and dry mouth, and he states that he hasn't had a bowel movement in 3 days, whereas he normally has one daily.

His vital signs are temperature 97.6 F, pulse 78/minute, blood pressure 130/79, and respirations 20/minutes. Based on this assessment, the nurse should suspect which of the following causes?
a. Possible toxicity
b. Cholinergic effects
c. Dehydration
d. Anticholinergic effects

Question 2

A nurse is checking on her patients during the night shift. One of the patients admitted with major depression complains of insomnia.

The nurse should notify the patient that she will discuss the insomnia with the prescriber, but she suspects that the prescriber may order which of the following drugs?
a. Venlafaxine (Effexor)
b. Mirtazapine (Remeron)
c. Bupropion (Wellbutrin)
d. Phenelzine (Nardil)

jesse.fleming · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: D
The signs and symptoms displayed by the patient are consistent with the anticholinergic effects common in patients taking amitriptyline.
There is no evidence of amitriptyline toxicity.
The patient is displaying anticholinergic, not cholinergic, signs and symptoms,.
The patient's findings are not consistent with dehydration, because his pulse rate is within normal limits and he is not hypotensive.

Answer to Question 2

ANS: B
Mirtazapine may cause somnolence and aid sleeping, because it has an increased release of serotonin.
Venlafaxine may actually contribute to the patient's insomnia and therefore would not be recommended for this patient.
Bupropion has the side effects of agitation, excitability, and insomnia and therefore would not be recommended for this patient.
Phenelzine can cause insomnia as a side effect and therefore would not be recommended for this patient.