Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition - Caring for Clients With Mood Disorders

Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition - Caring for Clients With Mood Disorders Related

Review Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition - Caring for Clients With Mood Disorders related questions and content

A nurse is caring for a client newly admitted to the emergency department. The nurse obtains the following vital signs: temperature, 101.6?°F; pulse rate, 92 beats/minute; respiratory rate, 28 breaths/minute; and blood pressure, 160/90 mmHg. The client appears disheveled and disoriented. Upon physical assessment, the nurse notes restlessness and muscle spasms with rigidity. Which documented finding in the health history is evaluated as a potential causative factor?

  • A. Mixing antibiotics with psychotherapeutic medications
  • B. Changing from one psychotherapeutic to another
  • C. Initiating psychotherapeutic drug therapy
  • D. Combining dairy products with psychotherapeutics
Correct Answer: B

Rationale: Serotonin syndrome is a potentially life-threatening condition that results from elevated levels of serotonin in the blood secondary to drug therapy. When reviewing the client's medication history and relating the symptoms assessed, the nurse relates the client's status with changing from one psychotherapeutic to another psychotherapeutic medication as a potential causative factor. There is no correlation from the client symptoms to combining antibiotic therapy with psychotherapeutics, initiating psychotherapeutics, or combining dairy products with psychotherapeutics.

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The nurse is completing a medication history for a client diagnosed with bipolar disorder. When assessing the medications, which medication classification is noted as an adjunct to lithium therapy?

  • A. Antidiabetics
  • B. Antihypertensives
  • C. Anticonvulsants
  • D. Antianginals
Correct Answer: C

Rationale: Anticonvulsant therapy may be co-prescribed for a brief period to sedate the client and relieve bizarre thought processes faster than monotherapy with lithium. Anticonvulsants enhance the action of gamma-aminobutyric acid (GABA) in much the same way that benzodiazepines reduce anxiety and they are believed to inhibit glutamate.

Which nursing consideration is most important when administering medications to a suicidal client?

  • A. Do not leave any syringe unattended.
  • B. Watch the client place all pills in the mouth.
  • C. View the inside of the mouth to make sure that all medications are swallowed.
  • D. Remove all medications and medication administration equipment from client area.
Correct Answer: C

Rationale: It is most important for the nurse to view the inside of the mouth when administering medications. This is done by inspecting the client's mouth and under the tongue because clients may 'cheek' medications to stockpile and use the medications. Not leaving syringes unattended, watching the client place the pills in their mouth, and removing all medications and equipment are all appropriate nursing actions, but the most important is not allowing the opportunity for the client to overdose on medications.

The nurse understands that clients who eat which of the following foods experience a food-drug interaction when taking phenelzine?

  • A. Tangerines
  • B. Fresh fish
  • C. Yogurt
  • D. Spinach and feta salad
Correct Answer: D

Rationale: The nurse understands that phenelzine is a monoamine oxidase inhibitor (MAOI). Clients who eat foods containing tyramine experience a food-drug interaction. When a MAOI is combined with foods containing tyramine (alcohol or aged cheese), a hypertensive crisis can occur. Feta cheese is an aged cheese. The other foods do not contain tyramine.

Administering an MAOI with food containing tyramine may develop a potentially fatal condition known as which of the following?

  • A. Psychosis
  • B. Serotonin syndrome
  • C. Hypertensive crisis
  • D. Hallucinations
Correct Answer: C

Rationale: When a MAOI is combined with foods containing tyramine, another monoamine, clients are likely to develop a potentially fatal hypertensive crisis, with symptoms such as elevated blood pressure and palpitations.

The nurse is providing instruction to a community class regarding seasonal affective disorder (SAD). Which gland and hormone would the nurse stress is responsible?

  • A. Thyroid gland and thyroxin
  • B. Pineal gland and melatonin
  • C. Pancreas and insulin
  • D. Pituitary gland and oxytocin
Correct Answer: B

Rationale: The hypothalamus relays the light-sensing data from the sun to the pineal gland. The pineal gland regulates the hormone melatonin. Melatonin also affects the regulation of serotonin, which affects mood.

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