The nurse is caring for a client taking fluoxetine for depression. Which assessment findings indicate that the medication is effective(Select all that apply.)
Improved sleep
Decreased anxiety
Reduced appetite
Weight loss
Correct Answer : A,B,E
A. Improved sleep is correct; an effective antidepressant can help normalize sleep patterns, which is a positive indicator of treatment efficacy.
B. Decreased anxiety is correct; fluoxetine is also effective in treating anxiety symptoms, so a reduction indicates the medication is working.
C. Reduced appetite is incorrect; while some individuals may experience appetite changes, a reduced appetite is not an indicator of effectiveness and could indicate a side effect.
D. Weight loss is incorrect; while weight loss can occur, it is not a definitive measure of the effectiveness of fluoxetine and can also signify side effects.
E. Interest in physical activity is correct; an increase in motivation and engagement in activities is a strong indicator of improvement in depressive symptoms.
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Correct Answer is A
Explanation
A. Phenylephrine is a decongestant that can raise blood pressure, making it contraindicated for individuals with hypertension. Advising a patient with hypertension to avoid phenylephrine is essential to prevent potential cardiovascular complications.
B. While patients with diabetes should be cautious about certain medications, phenylephrine is not specifically contraindicated in this condition.
C. A 17-year-old female with an upper respiratory infection typically does not have contraindications for phenylephrine unless there are underlying conditions not mentioned.
D. Gout does not have a direct contraindication for phenylephrine use, so the patient may not need to avoid it unless other health issues are present.
Correct Answer is B
Explanation
A. Decreased appetite may occur but is not the most critical concern in this context.
B. The combination of metoclopramide, which can influence serotonin pathways, with certain antidepressants, especially SSRIs, increases the risk of serotonin syndrome, a potentially life-threatening condition.
C. While some antidepressants can influence blood pressure, monitoring for elevated blood pressure is not the primary concern with metoclopramide.
D. There is no evidence to suggest that metoclopramide enhances the effects of antidepressants; the focus should be on potential adverse interactions instead.