2-4 weeks to work · lethal in overdose
Before you read
Test yourself first: 5 questions
Question 1 of 5
A client started on amitriptyline, a tricyclic antidepressant (TCA), reports dry mouth, constipation, blurred vision, and urinary hesitancy. The nurse recognizes these as which type of effect?
Answer: B. Tricyclic antidepressants have potent anticholinergic activity. Common anticholinergic side effects include dry mouth, constipation, blurred vision, urinary retention, and tachycardia. These can be managed with supportive measures while monitoring for the more dangerous cardiac and overdose risks.
Question 2 of 5
A client with neuropathic pain is most likely to benefit from which class of adjuvant medication?
Answer: A. Neuropathic pain often responds poorly to opioids alone and is treated with adjuvants such as anticonvulsants (gabapentin, pregabalin) and certain antidepressants (duloxetine, tricyclics). These agents target the abnormal nerve signaling that causes burning, shooting pain.
Question 3 of 5
A client taking an SSRI is being assessed at a follow-up visit. Which finding requires the nurse's most immediate attention?
Answer: B. A black-box warning for antidepressants is increased suicidal ideation, especially in young adults and early in treatment as energy improves before mood lifts. New or worsening thoughts of self-harm are a safety priority requiring immediate intervention. Mild nausea, headache, and decreased libido are common, manageable side effects.
Question 4 of 5
Which assessment finding is the nurse most concerned about in a client who has overdosed on a tricyclic antidepressant?
Answer: C. Tricyclic antidepressant overdose is dangerous primarily because of cardiotoxicity. TCAs block sodium channels, causing QRS widening, dysrhythmias, and hypotension, which are the leading cause of death in overdose. Cardiac monitoring is the priority.
Question 5 of 5
A client with severe neuropathic cancer pain is started on an adjuvant analgesic. Which medication should the nurse anticipate administering for neuropathic pain?
Answer: A. Adjuvant analgesics for neuropathic pain include certain anticonvulsants such as gabapentin, as well as tricyclic antidepressants and corticosteroids. Gabapentin is a common first-line choice. Antibiotics, antacids, and bulk-forming laxatives have no role in treating neuropathic pain.
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References
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