A client taking amitriptyline (Elavil) for two weeks tells the nurse that the medication "isn't working" because feelings of depression continue. Which response by the nurse is the most appropriate?
1. "This might not be the best medicine for you; I'll call your doctor."
2. "You might still feel depressed, but you are looking much better."
3. "It is working, but it can take several months to have an effect."
4. "It is working, but it can take several weeks to have an effect."
Correct Answer: 4
Rationale 1: It is inappropriate for the nurse to call the health care provider; tricyclic antidepressants need time to work.
Rationale 2: Telling depressed clients they look better negates their feelings and is inappropriate.
Rationale 3: The time frame for efficacy is several weeks, not several months.
Rationale 4: The therapeutic effects of tricyclic antidepressants can take 2–6 weeks to appear.
Global Rationale: The therapeutic effects of tricyclic antidepressants can take 2–6 weeks to appear. It is inappropriate for the nurse to call the health care provider; tricyclic antidepressants need time to work. Telling depressed clients they look better negates their feelings and is inappropriate. The time frame for efficacy is several weeks, not several months.
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