A patient with depression is taking a tricyclic antidepressant. The patient says, "I don't think I can keep taking these pills. They make me so dizzy, especially when I stand up." The nurse should:
a. explain how to manage hypotension, and educate the patient that side effects go away after several weeks.
b. tell the patient that the side effects are a minor inconvenience compared with the feelings of depression.
c. withhold the drug, force oral fluids, and notify the health care provider to examine the patient.
d. update the patient's mental status examination.
ANS: A
Drowsiness, dizziness, and postural hypotension usually subside after the first few weeks of therapy with tricyclic antidepressants. Postural hypotension can be managed by teaching the patient to stay well hydrated and rise slowly. Knowing these facts may be enough to convince the patient to remain medication compliant. The minor inconvenience of side effects as compared with feelings of depression is a convincing reason to remain on the medication. Withholding the drug, forcing oral fluids, and having the health care provider examine the patient are unnecessary steps. Independent nursing action is appropriate. Updating a mental status examination is unnecessary.
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