This topic contains a solution. Click here to go to the answer
« previous next »

Author Question: The primary care NP has prescribed sertraline (Zoloft) for a patient who initially reported daily ... (Read 90 times)

stephzh

  • Hero Member
  • *****
  • Posts: 556
on: Jul 24, 2018
The primary care NP has prescribed sertraline (Zoloft) for a patient who initially reported daily symptoms of hopelessness, sadness, insomnia, and weight loss.
 
  After several months of therapy, the patient no longer feels hopeless or sad but continues to have difficulty eating and sleeping. The NP should contact the patient's psychiatrist to discuss: a. adding mirtazapine (Remeron).
  b. changing to duloxetine (Cymbalta).
  c. adding another selective serotonin reuptake inhibitor (SSRI) antidepressant.
  d. an inpatient admission to the hospital.

Question 2

A primary care NP sees a patient who has fever, flank pain, and dysuria. The patient has a history of recurrent urinary tract infections (UTIs) and completed a course of trimethoprim-sulfamethoxazole (TMP/SMX) the week before.
 
  A urine test is positive for leukocyte esterase. The NP sends the urine for culture and should treat this patient empirically with: a. gemifloxacin.
  b. ciprofloxacin.
  c. azithromycin.
  d. TMP/SMX.


Related Topics

Need homework help now?

Ask unlimited questions for free

Ask a Question
Marked as best answer by a Subject Expert

snackralk

  • Sr. Member
  • ****
  • Posts: 363
Reply #1 on: Jul 24, 2018
Answer to Question 1

A
Mirtazapine may be added to the drug regimen for partial responders who continue to feel anxious. Changing medications is not recommended. Adding another SSRI is contraindicated because of the risk of serotonin syndrome. An inpatient hospital admission is not warranted.

Answer to Question 2

B
Fluoroquinolones are effective in treatment of UTIs that are resistant to other antibiotics. Because this patient recently completed a course of TMP/SMX, the NP can assume that the bacterium causing the infection is resistant to TMP/SMX. Gemifloxacin is not indicated for UTI, but ciprofloxacin is. Azithromycin is not a fluoroquinolone.


stephzh

  • Hero Member
  • *****
  • Posts: 556
Reply #2 on: Jul 24, 2018
TY


snackralk

  • Sr. Member
  • ****
  • Posts: 363
Reply #3 on: Jul 24, 2018
You're welcome


« previous next »
 

Did you know?

In 1864, the first barbiturate (barbituric acid) was synthesized.

Did you know?

To combat osteoporosis, changes in lifestyle and diet are recommended. At-risk patients should include 1,200 to 1,500 mg of calcium daily either via dietary means or with supplements.

Did you know?

Elderly adults are at greatest risk of stroke and myocardial infarction and have the most to gain from prophylaxis. Patients ages 60 to 80 years with blood pressures above 160/90 mm Hg should benefit from antihypertensive treatment.

Did you know?

By definition, when a medication is administered intravenously, its bioavailability is 100%.

Did you know?

The use of salicylates dates back 2,500 years to Hippocrates’s recommendation of willow bark (from which a salicylate is derived) as an aid to the pains of childbirth. However, overdosage of salicylates can harm body fluids, electrolytes, the CNS, the GI tract, the ears, the lungs, the blood, the liver, and the kidneys and cause coma or death.

Lung cancer. Photograph of part of a lung removed after death. The yellow area is a large tumor and Lung cancer. Photograph of part of a lung removed after death. The yellow area is a large tumor and
care care
Patient with osteoarthritis Patient with osteoarthritis
Skilled nursing facilities provide care for patients requiring longer stays than hospitals allow. Skilled nursing facilities provide care for patients requiring longer stays than hospitals allow.
A computerized patient registration form used by offices with electronic health records. A computerized patient registration form used by offices with electronic health records.
A histologic slide showing the sponge-like architecture of a patient with Creutzfeldt-Jakob Disease. A histologic slide showing the sponge-like architecture of a patient with Creutzfeldt-Jakob Disease.
Video: Proteins Defined, Hierarchy & Composition of Cells

For a complete list of videos, visit our video library