A nurse is caring for a client who has major depression and a new prescription for citalopram.
Which of the following adverse effects is the priority for the nurse to report to the provider?
Weight loss.
Confusion.
Bruxism.
Insomnia.
The Correct Answer is B
a. While weight changes can be concerning, they are not typically life-threatening and can occur as a common side effect of antidepressants, including citalopram. Monitoring is important, but it does not require immediate reporting.
b. This is the priority to report because confusion can indicate a serious reaction to the medication, such as serotonin syndrome, especially if it occurs in conjunction with other symptoms like agitation, hallucinations, or rapid heart rate. Confusion can also signal worsening mental status, which is critical for someone with major depression.
c. This refers to teeth grinding, which can occur with certain antidepressants. While it should be monitored and possibly addressed with interventions, it is generally not an immediate concern compared to confusion.
d. Sleep disturbances can be a side effect of citalopram and may need adjustment of treatment or recommendations for sleep hygiene, but they are not as urgent as confusion.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The nurse should plan to take the following action:
A) Mix the medications with a semisolid food for the client.
Mixing the medications with a semisolid food, such as applesauce or pudding, can make it easier for an older adult client with dysphagia to swallow the medications safely. It helps in reducing the risk of choking and aspiration. This approach is typically used for clients who have difficulty swallowing pills.
Options B, C, and D are not recommended for a client with dysphagia:
B) Administering more than one pill at a time can increase the risk of choking and aspiration, which should be avoided.
C) Placing medications on the back of the client's tongue can also lead to difficulty swallowing and an increased risk of aspiration.
D) Tilting the client's head back when administering medications is not recommended as it can lead to aspiration. The head should be kept in a neutral position to support safe swallowing.
Correct Answer is B
Explanation
This is because hydromorphone is a controlled substance and any unused portion should be discarded in the presence of a witness. Some possible explanations for the other choices are:
Choice A is wrong because storing the remaining half of the pill in the automated medication dispensing system could lead to errors in dosage or diversion of the drug.
Choice C is wrong because returning the remaining medication to the facility’s pharmacy is not a recommended practice for controlled substances and could also result in errors or diversion.
Choice D is wrong because placing the remaining half of the pill in the unit-dose package could compromise the integrity and stability of the medication and expose it to environmental factors.
Normal ranges for hydromorphone are not applicable as it is a synthetic opioid analgesic that does not have a therapeutic level.
However, some factors that may affect its pharmacokinetics and pharmacodynamics are age, weight, renal function, liver function, genetic polymorphisms, and drug interactions.
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