The patient tells the nurse that she plans to take St. John's wort to treat her depression. What is the best response by the nurse? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply

Question

1. "That should be fine as long as you are not suicidal."
2. "St. John's wort is successfully used in Europe for minor depression."
3. "It would be a good idea to try this before paying for a prescription medication."
4. "It would be better to have a psychiatric assessment first."
5. "Herbal preparations can interact with many other medications."

Answer 1

4,5
Rationale 1: The suicidality of the patient should not be a determining factor with using St. John's wort.
Rationale 2: Even though St. John's wort is successfully used in Europe, this does not mean it is appropriate for this patient.
Rationale 3: The cost of the prescription medication should not be a determining factor.
Rationale 4: Anyone who is depressed should have a psychiatric assessment prior to starting on any type of medication. Often, there is a physiological cause for the depression that must also be treated.
Rationale 5: Herbal preparations do interact with many other medications and can have serious adverse side effects.
Global Rationale: Anyone who is depressed should have a psychiatric assessment prior to starting on any type of medication. Often, there is a physiological cause for the depression that must also be treated. Herbal preparations do interact with many other medications and can have serious adverse side effects. The suicidality of the patient should not be a determining factor with using St. John's wort. Even though St. John's wort is successfully used in Europe, this does not mean it is appropriate for this patient. The patient should have a psychiatric assessment prior to trying St. John's wort; the cost of the prescription medication should not be a determining factor.