15. A nurse provided medication education for a patient diagnosed with major depression who began a new prescription for phenelzine (Nardil). Which behavior indicates effective learning? The patient:a. monitors sodium intake and weight daily.b. wears support stockings and elevates the legs when sitting.c. can identify foods with high selenium content that should be avoided.d. confers with a pharmacist when selecting over-the-counter medications.ANS: D Over-the-counter medicines may contain vasopressor agents or tyramine, a substance that must be avoided when the patient takes MAOI antidepressants. Medications for colds, allergies, or congestion or any preparation that contains ephedrine or phenylpropanolamine may precipitate a hypertensive crisis. MAOI antidepressant therapy is unrelated to the need for sodium limitation, support stockings, or leg
elevation. MAOIs interact with tyramine-containing foods, not selenium, to produce dangerously high blood pressure.16. Major depression resulted after a patient’s employment was terminated. The patient now says to the nurse, “I’m not worth the time you spend with me.I am the most useless person in the world.” Which nursing diagnosis applies?The patient’s statements express feelings of worthlessness and most clearly relate to the nursing diagnosis of situational low self-esteem. Insufficient information exists to lead to other diagnoses.17. A patient diagnosed with major depression does not interact with others except when addressed, and then only in monosyllables. The nurse wants to show nonjudgmental acceptance and support for the patient. Which communication technique will be effective?Making observations about neutral topics such as the environment draws the patient into the reality around him or her but places no burdensome expectations for answers on the patient. Acceptance and support are shown by the nurse’s presence. Direct questions may make the patient feel that the encounter is an interrogation. Open-ended questions are preferable if the patient is able to participate in dialogue. Platitudes are never acceptable. They minimize patient feelings and can increase feelings of worthlessness.
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- Spring '08
- Selective serotonin reuptake inhibitor, Major depressive disorder, Antidepressant