A nurse onapostpartum unit is caring for a client.

Exhibits

Which of the following provider's prescriptions should the nurse anticipate? Select all that apply?

Rationale:
A. Advise the adolescent to place the newborn for adoption: Suggesting adoption may be perceived as judgmental and does not address the adolescent’s immediate concern about accessing resources and caring for the baby.

B. Refer the adolescent to a local mental health clinic: While emotional support can be beneficial, referral to mental health services alone does not address practical concerns about affording and caring for the baby. Immediate assistance with resources is a priority.

C. Contact the adolescent's parent for assistance: Confidentiality and the adolescent’s autonomy must be respected unless there is a safety concern. The nurse should not contact parents without the adolescent’s consent.

D. Assist the adolescent in applying for Medicaid: Helping the adolescent apply for Medicaid directly addresses her concerns about affording prenatal care and infant needs. This action provides practical support, empowers her to access healthcare and resources, and promotes positive maternal and fetal outcomes.

Rationale:
A. "I know it will be a couple of weeks before the medication helps me feel better.": Tricyclic antidepressants like amitriptyline require 1–3 weeks to begin showing therapeutic effects. Understanding the delayed onset helps the client maintain adherence and avoid premature discontinuation due to perceived lack of efficacy.

B. "I can continue to take St. John's wort while taking this medication.": Combining amitriptyline with St. John’s wort can increase the risk of serotonin syndrome. Clients should avoid herbal supplements that may interact with antidepressants.

C. "I expect this medication to raise my blood pressure.": Amitriptyline more commonly causes orthostatic hypotension rather than hypertension. Clients should be aware of potential dizziness and fall risk associated with blood pressure drops.

D. "I should take this medication on an empty stomach": Incomplete statement, but typically, amitriptyline is taken at bedtime to minimize daytime sedation and anticholinergic side effects. Timing should be clarified to optimize safety and adherence.