The nurse is teaching a client who is being discharged from the hospital. The client will be going home on morphine sulfate therapy

Question

The client tells the nurse that at home, the client was using St. John's wort as a natural treatment for depression, and asks if it is all right to continue taking this herb. What is the nurse's best response?
1. "If it is a natural substance, it should be OK, and you should not have to worry about any drug interactions."
2. "Why are you using an herb? You could treat your depression better with conventional medication."
3. "St. John's wort can decrease the analgesic effect of morphine sulfate. You might want to wait until you no longer need pain management."
4. "As long as you don't take them at the same time, you should be OK. Just space them about two hours apart."

Answer 1

Correct Answer: 3
Rationale 1: Most natural substances can interact with conventional medications. St. John's wort can actually decrease the analgesic effects of morphine sulfate.
Rationale 2: This answer does not address the client's concern about drug interaction, and is a judgmental statement about the client's current method of dealing with depression.
Rationale 3: St. John's wort can decrease the analgesic effects of morphine sulfate. The client should wait until morphine sulfate therapy is discontinued before restarting the herb.
Rationale 4: St. John's wort can actually decrease the analgesic effects of morphine sulfate. The client should wait until morphine sulfate therapy is finished before starting the herbal therapy again.
Global Rationale: St. John's wort can decrease the analgesic effects of morphine sulfate. The client should wait until morphine sulfate therapy is discontinued before restarting the herb. Most natural substances can interact with conventional medications. St. John's wort can actually decrease the analgesic effects of morphine sulfate. Asking the client why the herb is used does not address the client's concern about drug interaction, and is a judgmental statement about the client's current method of dealing with depression.