Author Question: A patient is admitted to a long-term psychiatric setting. The MAOI medication previously prescribed ... (Read 23 times)

leilurhhh · **on:** Jul 24, 2018

A patient is admitted to a long-term psychiatric setting. The MAOI medication previously prescribed is discontinued by the physician. New orders are obtained to initiate imipramine therapy.

The nurse will provide the first dose of imipramine to the patient _____ the MAOI drug.
a. immediately following the last dose of
b. in 1 week following the last dose of
c. in 14 days following the last dose of
d. before discontinuing

Question 2

Which instruction(s) is/are most pertinent to include in the discharge teaching of a patient on lithium (Eskalith) who is being discharged? (Select all that apply.)

a. Persistent vomiting and profuse diarrhea are signs of toxicity and must be reported to the health care provider immediately.
b. It is important to comply with schedules for blood tests to assess therapeutic levels.
c. You should avoid foods such as Chianti wine and aged cheeses.
d. The common adverse effects to expect, which are excessive nausea, anorexia, and abdominal cramps, tend to resolve.
e. You will be gradually weaned off this medication.
f. Take the medication with food or milk.

lolol · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

ANS: C
MAOIs and TCAs, especially imipramine and desipramine, should not be administered concurrently. It is recommended that at least 14 days lapse between discontinuing an MAOI and starting SSRI/SNRI therapy.

Answer to Question 2

ANS: A, B, D, F
Patients should be informed of the importance of toxic symptoms to report and monitoring therapeutic lithium levels. Nausea, vomiting, and abdominal cramps are common adverse effects and tend to resolve. Lithium should be administered with food or milk. Chianti wine and aged cheeses are to be avoided during MAOI therapy. The bipolar patient may be on lithium treatment for the rest of his or her life and will not be weaned from the medication.