A patient who is taking amitriptyline (Elavil) reports constipation and dry mouth. The nurse will give the patient which instruction?
Stop taking the medication immediately.
Increase fluid intake.
Request another antidepressant.
Notify the provider.
The Correct Answer is B
A) Stop taking the medication immediately: Abruptly stopping amitriptyline without the guidance of a healthcare provider can cause withdrawal symptoms and other complications. Discontinuing this medication should only be done under medical supervision.
B) Increase fluid intake: Amitriptyline can cause anticholinergic side effects such as dry mouth and constipation. Increasing fluid intake helps manage dry mouth by stimulating salivation and helps alleviate constipation by promoting bowel regularity.
C) Request another antidepressant: While amitriptyline can cause side effects like dry mouth and constipation, switching medications should not be the first step. These side effects are often manageable with lifestyle modifications, such as increasing fluid and fiber intake, and adjustments to the treatment plan can be considered if the symptoms are severe or persistent.
D) Notify the provider: While it is important for the nurse to document and inform the provider about any significant side effects, this instruction alone does not provide immediate relief to the patient. It is more appropriate to first recommend increasing fluid intake, and then the nurse can discuss with the provider if the symptoms persist or worsen.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) Interferon-B (IFN-B): Interferon-beta is a disease-modifying therapy (DMT) used for multiple sclerosis (MS) to reduce the frequency and severity of attacks and slow disease progression. However, it is not typically used during an acute exacerbation of MS. It is more commonly prescribed for long-term management of the disease.
B) Mitoxantrone: Mitoxantrone is an immunosuppressive agent that is used as a disease-modifying therapy for patients with more aggressive forms of MS. While it can be helpful in reducing the frequency of attacks, it is not the first-line treatment during an acute relapse. Mitoxantrone is often considered for long-term use when other therapies are not effective.
C) Glatiramer acetate (Copaxone): Glatiramer acetate is another disease-modifying therapy for MS. It works by altering the immune response to protect the myelin sheath. Like interferon-beta, it is used for long-term management, not for acute attacks. It is not typically used during an exacerbation of MS.
D) Methylprednisolone (Solu-Medrol): Methylprednisolone, a corticosteroid, is the standard treatment for acute exacerbations of multiple sclerosis. It works by reducing inflammation, which helps to decrease the severity of symptoms during an MS relapse. The nurse would anticipate this drug being prescribed to manage the acute inflammatory episode and speed recovery from the attack. This medication is often administered intravenously in high doses and then tapered as the patient stabilizes.
Correct Answer is A
Explanation
A) Beta 1: Beta-1 adrenergic receptors are primarily located in the heart and are responsible for increasing heart rate (chronotropy), the force of contraction (inotropy), and the conduction speed of electrical impulses within the heart (dromotropy). When a drug is given to increase heart rate and myocardial activity, it is stimulating the beta-1 receptors, which enhance the heart's performance..
B) Beta 2: Beta-2 receptors are predominantly found in smooth muscles, such as those
in the bronchi, blood vessels, and uterus. Stimulation of beta-2 receptors leads to relaxation of these muscles, including bronchodilation and vasodilation, which would not have a direct effect on increasing heart rate or myocardial activity.
C) Alpha 2: Alpha-2 receptors are primarily located in the central nervous system (CNS) and act to inhibit the release of norepinephrine, leading to a reduction in sympathetic nervous system activity. They have the opposite effect of what is desired in this case, as stimulation of alpha-2 receptors would actually lower heart rate and decrease myocardial activity, not increase it.
D) Alpha 1: Alpha-1 receptors are found in the smooth muscle of blood vessels and when stimulated, cause vasoconstriction, which increases blood pressure. While alpha-1 receptors do affect the cardiovascular system, they do not directly influence heart rate or myocardial contractility.
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