A patient has been taking paroxetine (Paxil) for major depressive symptoms for 8 months. The patient tells the primary care NP that these symptoms improved after 2 months of therapy
The patient is experiencing weight gain and sexual dysfunction and wants to know if the medication can be discontinued. The NP should: a. change to a tricyclic antidepressant medication.
b. begin to taper the paroxetine and instruct the patient to call if symptoms increase.
c. tell the patient to stop taking the medication and to call if symptoms get worse.
d. continue the medication for several months and consider adding bupropion (Wellbutrin).
D
Once a patient achieves remission, a continuation phase of 16 to 20 weeks followed by a maintenance phase of 4 to 9 months should be carried out. Some responders, called apathetic responders, may have a decrease in most symptoms but continue to have lack of pleasure, decreased libido, and lack of energy. Bupropion can be added to therapy to treat these symptoms. Patients should not change medications during this phase, should not begin a drug taper, and should never stop the medication abruptly.
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A physiotherapist (PT) at an assisted living facility for older adults is leading an exercise class for the residents
Part of the PT's introductory class is an explanation of the health problems that can be mitigated by physical activity and those that are considered inevitabilities of the aging process. Which of the following phenomena would the PT most justifiably characterize as modifiable? A) Reduction in density of the trabecular bone B) Gradual decline in physical reaction time C) Overall reduction in muscle strength D) Decline in height
After teaching a couple about what to expect with their planned cesarean birth, which statement indicates the need for additional teaching?
A) "Holding a pillow against my incision will help me when I cough.". B) "I'm going to have to wait a few days before I can start breast-feeding.". C) "I guess the nurses will be getting me up and out of bed rather quickly.". D) "I'll probably have a tube in my bladder for about 24 hours or so.".
Which of the following are common factors of conflict encountered in nursing? (Select all that apply.)
a. Ambiguous boundaries around work re-sponsibilities b. Unclear communication to family mem-bers about visiting hours c. Nursing assistant placing personal achievement above everything d. Chief of medicine demanding that the nurse/patient ratio be increased e. Consideration of 26-week termination of pregnancy by a physician because of mother's health f. Vacation schedules posted with new staff members having to work at least one day during all holidays
A patient has reduced muscle strength following a left-sided stroke and is at risk for falling. Which intervention is most appropriate for the nursing diagnostic statement Risk for falls?
a. Keep all side rails down at all times. b. Encourage patient to remain in bed most of the shift. c. Place patient in room away from the nurses' station if possible. d. Assist patient into and out of bed every 4 hours or as tolerated.