An older woman who takes escitalopram (Lexapro) 10 mg by mouth daily states she does not feel better after 1 week of treatment
Rank the interventions in order, starting with the first inter-vention the nurse should implement to facilitate patient compliance with therapy. a. Tell her that the beneficial effects can take 4 to 6 weeks to appear.
b. Instruct her to take the medication as pre-scribed without stopping.
c. Suggest hard candy, ice chips, and sips of water for a dry mouth.
d. Collaborate with the health care provider to provide an increased dose.
A, B, C, D
Usually, older adults are sensitive to the effects of medications, but under normal circumstances, the therapeutic effect of escitalopram and other SSRI antidepressant medications can take up to 4 to 6 weeks to appear. Conversely, if an individual who is taking an antidepressant experiences adverse effects of the medication, then the individual should be instructed to take the medication continually as prescribed for 1 to 2 months before abandoning the therapy; the untoward effects usually diminish or disappear with time. To bolster the initial intervention, the nurse instructs the older adult to continue therapy without stopping because consistent, daily administration is the best method of achieving the full beneficial effects of an antidepressant. A common, early ad-verse effect of antidepressant therapy is dry mouth; therefore the nurse supplies the individual with strategies for effectively counteracting the anticholinergic effects of this medication. The nurse assists the older adult with strategies to manage antidepressant therapy before asking for an increased dose. Titration of an antidepressant medication for an older adult is a slow process be-cause of increased sensitivity to the effects of the medication. In addition, dosing trial and error is a common strategy for determining an individual's optimal dose.
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