A client who has neuropathy of the lower extremities is prescribed an opioid analgesic for pain. The provider adds a tricyclic antidepressant medication (TCA) for pain management. The client asks the nurse, "Why am I getting this new drug?
I am not depressed, my feet just burn." What is the best response from the nurse?
1. "This drug will also help with the nerve pain you are having in your feet."
2. "It is to help you sleep at night instead of using the opioid."
3. "Sometimes people get depressed with chronic pain."
4. "Maybe this is a mistake, if you are not depressed."
Correct Answer: 1
Rationale 1: TCAs are often added as an adjuvant medication in neuropathic pain management, as with this client.
Rationale 2: While a benefit of TCA administration is that the client often sleeps better at night, this is not the reason the drug is being added to this client's regimen.
Rationale 3: Although clients might become depressed with chronic pain, the TCA is used for neuropathic pain management.
Rationale 4: In this case the purpose of the antidepressant does not involve depression.
Global Rationale: TCAs are often added as an adjuvant medication in neuropathic pain management, as with this client. While a benefit of TCA administration is that the client often sleeps better at night, this is not the reason the drug is being added to this client's regimen. Although clients might become depressed with chronic pain, the TCA is used for neuropathic pain management. In this case the purpose of the antidepressant does not involve depression.
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