A nurse is caring for a client who has major depressive disorder and was prescribed citalopram 2 weeks ago with a planned dosage increase 1 week ago. The client reports having an improved appetite, but still feels very depressed and is still having trouble sleeping. Which of the following actions should the nurse take?
Speak to the provider about adding an MAOI to the current medication regimen.
Explain that antidepressants often take several weeks to be fully effective.
Tell the client that the provider will need to change citalopram to a different medication.
Recommend a sleep study be done on the client
The Correct Answer is B
This action might be premature. MAOIs (Monoamine Oxidase Inhibitors) are a class of antidepressants with specific dietary and medication interactions. They are typically considered when other classes of antidepressants have not been effective. It's important to exhaust other options before considering a switch to MAOIs.
B. Explain that antidepressants often take several weeks to be fully effective:
Explanation: Correct Answer. This is an appropriate response. Antidepressants, including citalopram, can take several weeks to show their full therapeutic effects. It's common for some symptoms to improve before others. Educating the client about the delayed onset of action is important to manage their expectations.
C. Tell the client that the provider will need to change citalopram to a different medication:
Explanation: It might be too early to consider changing the medication after just two weeks, especially since the client reports an improved appetite. Changes in dosage or medication should ideally be discussed with the provider after an adequate trial period.
D. Recommend a sleep study be done on the client:
Explanation: While sleep problems can be associated with depression, it might not be the most appropriate next step based solely on the information provided. It's more important to address the ongoing depressive symptoms before focusing solely on sleep.
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Related Questions
Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"B"}
No explanation
Correct Answer is B
Explanation
Fluoxetine and other SSRIs can actually have an impact on sexual desire and function as a side effect, often leading to decreased libido. This statement shows a misunderstanding of the medication's potential effects.
B. "I should notify my provider if I develop a skin rash."
Explanation: Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat depression. It's important for clients to be aware of potential side effects and know when to notify their healthcare provider. One potential serious side effect is an allergic reaction or skin rash, which could indicate an adverse response to the medication. Therefore, the client's statement about notifying the provider if a skin rash develops demonstrates their understanding of monitoring for potential adverse reactions.
C. "I should expect relief from depression within 3 to 4 days."
Antidepressant medications like fluoxetine typically take several weeks to start showing significant improvements in symptoms. This statement reflects a misconception about the timeline for therapeutic effects.
D. "I will take my fluoxetine at bedtime so I can sleep better."
Fluoxetine can have stimulating effects for some individuals, so it's often recommended to take it earlier in the day to avoid interference with sleep. Taking it at bedtime could potentially disrupt sleep rather than improve it.
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