A nurse is teaching a client who has a new prescription for an antacid to treat a gastric ulcer. Which of the following statements by the client indicates an understanding of the teaching?

Choice A reason: Monoamine oxidase inhibitors (MAOIs) are not the correct class of medications to which escitalopram (Lexapro) belongs. MAOIs are a group of antidepressants that work by inhibiting the enzyme monoamine oxidase, which breaks down neurotransmitters such as serotonin, norepinephrine, and dopamine. MAOIs can increase the levels of these neurotransmitters in the brain and improve mood and energy. However, MAOIs can also cause serious side effects and interactions with other drugs and foods, and they are not commonly used as firstline treatment for depression. Escitalopram is not an MAOI, and it should not be taken with MAOIs or within 14 days of stopping or starting MAOIs, as this can cause a dangerous drug interaction called serotonin syndrome.

Choice B reason: Betablockers are not the correct class of medications to which escitalopram (Lexapro) belongs. Betablockers are a group of drugs that work by blocking the beta receptors on the heart and blood vessels, which are stimulated by adrenaline and noradrenaline. Betablockers can lower the heart rate, blood pressure, and cardiac output, and they are used to treat conditions such as hypertension, angina, arrhythmias, and heart failure. Betablockers can also reduce anxiety and tremors, but they are not antidepressants and they do not affect serotonin levels. Escitalopram is not a betablocker, and it does not have any significant effect on the cardiovascular system.

Choice C reason: Benzodiazepines are not the correct class of medications to which escitalopram (Lexapro) belongs. Benzodiazepines are a group of drugs that work by enhancing the activity of the neurotransmitter gammaaminobutyric acid (GABA), which has a calming and sedating effect on the brain. Benzodiazepines are used to treat anxiety, insomnia, seizures, and muscle spasms, and they can also cause relaxation, drowsiness, and amnesia. Benzodiazepines are not antidepressants and they do not affect serotonin levels. Escitalopram is not a benzodiazepine, and it does not have any significant effect on GABA receptors .

Choice D reason: Selective serotonin reuptake inhibitors (SSRIs) are the correct class of medications to which escitalopram (Lexapro) belongs. SSRIs are a group of antidepressants that work by blocking the reuptake of serotonin by the nerve cells, which increases the availability of serotonin in the synaptic cleft. Serotonin is a neurotransmitter that regulates mood, appetite, sleep, and cognition, and low levels of serotonin are associated with depression and anxiety. SSRIs can improve the symptoms of depression and anxiety by enhancing the serotonin signaling in the brain. Escitalopram is an SSRI, and it is used to treat major depressive disorder and generalized anxiety disorder.

Choice A reason: This is correct. Hypertension is a contraindication for taking pseudoephedrine. Pseudoephedrine is a decongestant that shrinks the blood vessels in the nasal passages and relieves congestion. However, it can also increase the blood pressure and the heart rate, which can worsen hypertension and increase the risk of stroke, heart attack, or kidney damage. The nurse should advise the client to avoid pseudoephedrine and use other methods to relieve sinus congestion, such as saline nasal spray, steam inhalation, or humidifier.

Choice B reason: This is incorrect. Diverticulitis is not a contraindication for taking pseudoephedrine. Diverticulitis is a condition where small pouches in the colon become inflamed and infected. It can cause symptoms such as abdominal pain, fever, nausea, or constipation. Pseudoephedrine does not affect the colon or the inflammation directly, but it can cause dehydration, which can worsen constipation and diverticulitis. The nurse should advise the client to drink plenty of fluids and eat a highfiber diet to prevent constipation and diverticulitis.

Choice C reason: This is incorrect. Migraines are not a contraindication for taking pseudoephedrine. Migraines are severe headaches that are often accompanied by nausea, vomiting, or sensitivity to light and sound. They can be triggered by various factors, such as stress, hormones, or food. Pseudoephedrine does not cause migraines directly, but it can interact with some migraine medications, such as triptans, which are used to treat acute migraine attacks. The combination of pseudoephedrine and triptans can increase the blood pressure and the risk of serotonin syndrome, a serious condition that causes agitation, confusion, tremors, or seizures. The nurse should advise the client to check with their doctor before taking pseudoephedrine and triptans together.

Choice D reason: This is incorrect. Eczema is not a contraindication for taking pseudoephedrine. Eczema is a skin condition that causes dry, itchy, and inflamed skin. It can be caused by various factors, such as allergies, irritants, or genetics. Pseudoephedrine does not affect the skin or the inflammation directly, but it can cause dryness of the mucous membranes, such as the mouth, nose, or eyes. The nurse should advise the client to use a moisturizer, a lip balm, and artificial tears to prevent dryness and irritation of the skin and the mucous membranes.