A nurse cares for four patients who are receiving clozapine, lithium, fluoxetine, and venlafaxine, respectively. For which patient should the nurse be most alert for alterations in cardiac or cerebral electrical conductivity as well as fluid and electrolyte imbalance? The patient receiving:
fluoxetine (Prozac)
Lithium (Lithobid)
venlafaxine (Effexor)
clozapine (Clozari)
The Correct Answer is B
A. fluoxetine (Prozac):
Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat depression and anxiety disorders. While SSRIs can have side effects, significant alterations in cardiac or cerebral electrical conductivity and fluid/electrolyte imbalance are not typically associated with fluoxetine. The primary concerns with SSRIs are related to serotonin levels and can include gastrointestinal disturbances, insomnia, and sexual dysfunction.
B. Lithium (Lithobid):
This is the correct answer. Lithium is known to have potential side effects related to cardiac and cerebral function, as well as fluid and electrolyte balance. Monitoring blood levels of lithium is crucial to avoid toxicity, which can affect the cardiovascular and central nervous systems. Lithium toxicity can lead to symptoms such as tremors, confusion, ataxia, and, in severe cases, seizures.
C. venlafaxine (Effexor):
Venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI) commonly used to treat depression and anxiety disorders. While it can cause some cardiovascular effects, the concern for significant alterations in cardiac or cerebral electrical conductivity and fluid/electrolyte imbalance is generally lower compared to lithium. The primary side effects of venlafaxine are related to serotonin and norepinephrine levels and may include increased blood pressure and heart rate.
D. clozapine (Clozaril):
Clozapine is an atypical antipsychotic medication used to treat schizophrenia. While antipsychotics can have side effects related to metabolic changes, significant alterations in cardiac or electrolyte imbalances are not typically associated with clozapine as the primary concern. Regular monitoring for metabolic side effects, such as weight gain and changes in lipid and glucose levels, is important with antipsychotic medications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. "This therapy will increase the client's motivation to gain weight": Behavior modification focuses on changing specific behaviors through reinforcement or consequences. While motivation may be a component, the primary goal of behavior modification is to address and modify specific behaviors, such as eating habits, rather than solely relying on motivation.
B. "This therapy will provide the client with control over behavioral choices": Anorexia nervosa often involves issues of control, and behavior modification can empower the individual to regain control over their eating behaviors in a structured and supportive manner. It involves setting goals, reinforcing positive behaviors, and providing a sense of control within the therapeutic framework.
C. "This therapy will reward the client for perfectionist achievement": While anorexia nervosa is associated with perfectionism, rewarding for perfectionist achievement may inadvertently reinforce unhealthy behaviors. Behavior modification aims to promote positive behaviors related to health and well-being rather than reinforcing perfectionism.
D. "This therapy will protect the client from parental overindulgence": Behavior modification is not primarily focused on protecting the client from external factors like parental overindulgence. Instead, it aims to modify specific behaviors through positive reinforcement or consequences.
Correct Answer is A
Explanation
A. Note escalating behaviors and intervene immediately:
This option prioritizes the client's safety by addressing escalating behaviors promptly. Bizarre behaviors, neologisms, and thought insertion may indicate a severe episode of psychosis, and timely intervention is crucial to prevent harm to the client or others.
B. Interpret attempts at communication:
While understanding and interpreting communication are important, in a situation with escalating behaviors and potential safety concerns, immediate intervention takes precedence. Communication interpretation can follow once the safety of the client has been ensured.
C. Assess for medication noncompliance:
Medication noncompliance can contribute to exacerbation of symptoms, but in an acute situation where safety is a concern, addressing immediate behaviors takes precedence. Medication assessment can be done in the context of a more comprehensive assessment after the immediate safety concerns have been addressed.
D. Assess triggers for bizarre, inappropriate behaviors:
Identifying triggers is important for understanding the underlying causes of the behavior, but in the context of escalating behaviors and potential safety issues, immediate intervention to de-escalate the situation is the priority. Triggers can be explored once the immediate safety concerns are addressed.
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