Greene is an 85-year-old male placed on a 5150 by the crisis team after his nurse called them. He has taken a fall in his driveway after his dialysis. He has end-stage kidney disease, diabetes, and a history of myocardial infarction 4 years ago. He was living alone until his home health nurse found him crying out in pain, clutching onto his leg in the kitchen. “I’m so tired,” he says.Nortriptyline and some tricyclic antidepressants may be helpful with neuropathic pain but are often contraindicated in elderly clients such as Mr. Greene because (select the best answer)
Are outdated medications
Can increase cardiac side effects and urinary retention
Are only taken at night
Are expensive
Are expensive
The Correct Answer is B
Choice A reason:
While some may consider tricyclic antidepressants outdated, they are still used for certain conditions, including neuropathic pain. The primary concern with their use in elderly clients is not their age but their side effect profile.
Choice B reason:
Tricyclic antidepressants, including nortriptyline, can increase cardiac side effects and urinary retention, which are significant concerns in elderly clients. These medications can cause orthostatic hypotension, arrhythmias, and exacerbate urinary retention, making them less suitable for older adults with pre-existing health conditions.
Choice C reason:
The timing of medication administration (e.g., only taken at night) is not the primary issue with tricyclic antidepressants. The concern lies in their side effects, which can be particularly problematic for elderly clients.
Choice D reason:
While the cost of medication can be a factor in treatment decisions, it is not the primary reason tricyclic antidepressants are contraindicated in elderly clients. The main concern is their potential to cause serious side effects.
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Correct Answer is D
Explanation
Choice A reason:
Adolescents can experience social isolation and mental health challenges, but they are not the age group most likely to face chronic health problems that lead to suicidal risk. While adolescent suicide is a serious concern, older adults are more prone to chronic health issues and social isolation.
Choice B reason:
Young adults may also face social isolation and mental health issues, but they generally have fewer chronic health problems compared to older adults. The combination of social isolation and chronic health conditions is more prevalent in the geriatric population.
Choice C reason:
Middle-aged adults can experience significant stressors, such as career pressures and family responsibilities, which may contribute to mental health issues. However, they are not the age group most at risk for social isolation and chronic health problems leading to suicidal risk.
Choice D reason:
Geriatric or older adults are the age group most likely to be at risk for social isolation and have chronic health problems that lead to suicidal risk. Older adults often face multiple chronic health conditions, loss of loved ones, and reduced social networks, all of which can contribute to feelings of isolation and increased suicidal risk. Addressing these issues through social support and healthcare interventions is crucial for this population.
Correct Answer is D
Explanation
Choice A reason:
The statement “The stress of nursing school will cause depression” is not accurate according to the Diathesis-Stress Model. While stress can contribute to the development of depression, the model emphasizes the interaction between genetic vulnerabilities and environmental stressors, not a direct cause-and-effect relationship.
Choice B reason:
“Depression is a result of cultural and religious perspectives” is not a statement supported by the Diathesis-Stress Model. This model focuses on the interplay between genetic predispositions and environmental stressors, rather than cultural or religious factors alone.
Choice C reason:
“The stress of parenting often causes depression” is an oversimplification. While parenting can be stressful and may contribute to depression in some individuals, the Diathesis-Stress Model highlights the importance of genetic vulnerabilities interacting with life stressors to trigger depression.
Choice D reason:
“People with genetic vulnerabilities can develop depression with added stress of life events” accurately reflects the Diathesis-Stress Model. This model posits that individuals with a genetic predisposition to depression are more likely to develop the condition when exposed to significant stressors, such as life events or environmental challenges.