The risk of experiencing serotonin syndrome is increased when SSRIs are given with monoamine oxidase inhibitors such as phenelzine (Nardil). Serotonin syndrome is best characterized in which of the following?
Tea-colored urine and constipation
A productive cough and vomiting
Muscle rigidity and high fever
Hypotension and urinary retention
The Correct Answer is C
Choice A reason:
Tea-colored urine and constipation are not characteristic symptoms of serotonin syndrome. These symptoms may indicate other medical conditions but are not related to the excessive accumulation of serotonin in the body.
Choice B reason:
A productive cough and vomiting are not typical symptoms of serotonin syndrome. While vomiting can occur in severe cases, a productive cough is unrelated to serotonin syndrome and more indicative of respiratory conditions.
Choice C reason:
Muscle rigidity and high fever are hallmark symptoms of serotonin syndrome. This condition results from an excess of serotonin in the central nervous system and can lead to severe autonomic instability, hyperthermia, and neuromuscular abnormalities. Immediate medical intervention is required to manage these symptoms and prevent complications.
Choice D reason:
Hypotension and urinary retention are not primary symptoms of serotonin syndrome. While autonomic dysfunction can occur, the key features of serotonin syndrome include neuromuscular hyperactivity, autonomic instability, and altered mental status.
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Correct Answer is B
Explanation
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While some may consider tricyclic antidepressants outdated, they are still used for certain conditions, including neuropathic pain.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.
Correct Answer is ["B","C","D"]
Explanation
Choice A reason:
Canceling Netflix by Internet service is not relevant to Mr. Jones’ discharge planning. While managing finances and subscriptions may be part of overall life management, it does not address the immediate safety and mental health needs of Mr. Jones.
Choice B reason:
Releasing information signed for family to secure Mr. Jones’ loaded gun or having the police secure the gun if needed prior to discharge is crucial for ensuring his safety. Removing access to firearms reduces the risk of self-harm and is an important step in discharge planning for someone with suicidal ideation.
Choice C reason:
Obtaining a psychiatric provider follow-up appointment as soon as possible and evaluating for PHP (Partial Hospitalization Program) or residential treatment with the treatment team is essential. Continuity of care and appropriate follow-up are critical for managing Mr. Jones’ depression and preventing relapse.
Choice D reason:
Assisting in developing a safety plan prior to discharge that is written with phone numbers and interventions is vital. A safety plan provides Mr. Jones with clear steps to take if he feels at risk of harming himself, including contact information for crisis services and supportive individuals.