Question

The physician has prescribed sertraline (Zoloft) \(50 \mathrm{mg}\) daily for a client with depression. Which finding should be reported to the physician? A. The client takes cimetidine (Tagamet) for acid reflux. B. The client takes the medication with meals. C. The client takes the medication once a day at bedtime. D. The client takes naproxen (Naprosyn) for arthritis.

Short answer

A. The client also takes cimetidine. B. The client takes the medication with meals. C. The client takes the medication once a day at bedtime. D. The client also takes naproxen. Answer: A and D Explanation: Both Option A and Option D involve drug interactions that may potentially lead to increased side effects and risks for the client. Cimetidine may increase sertraline levels and effects, while using sertraline and naproxen together may increase the risk of bleeding. These concerns should be reported to the physician. Options B and C are not concerns that need reporting, as sertraline can be taken with or without food and either in the morning or evening.

Step-by-step solution

Evaluate Option A: Cimetidine interaction

We need to research whether there's an interaction between sertraline and cimetidine that should be reported to the physician. According to medication resources, cimetidine may increase the levels and effects of sertraline, which can potentially lead to increased side effects. This is a potential issue that should be reported.

Evaluate Option B: Taking medication with meals

We need to consider whether taking sertraline with meals is an issue. According to the medication guidelines, sertraline can be taken with or without food. There is no problem with taking it with meals, so this is not a concern that needs reporting.

Evaluate Option C: Taking medication at bedtime

We need to determine if taking sertraline once a day at bedtime is an issue. According to the medication guidelines, sertraline can be taken once daily, either in the morning or evening. Taking it at bedtime is not a concern, so this doesn't need to be reported.

Evaluate Option D: Naproxen interaction

We need to research whether there's an interaction between sertraline and naproxen that should be reported to the physician. According to medication resources, using sertraline together with naproxen may increase the risk of bleeding. This is a potential issue that should be reported. #Conclusion#: We should report Option A and Option D to the physician, as they involve drug interactions that can potentially lead to increased side effects and risks for the client. Options B and C are not concerns that need reporting.

Key concepts

Pharmacology

Pharmacology is the study of how drugs interact with the body and how the body affects the drugs. This includes understanding the drug's mechanism of action, absorption, distribution, metabolism, and excretion.
Pharmacology helps healthcare providers understand which medications are most effective for certain conditions.
By understanding a drug's pharmacokinetics and pharmacodynamics, nurses can properly assess medication impacts on patients' health and modify treatment plans accordingly. When considering medications like sertraline (Zoloft) and cimetidine (Tagamet), it's crucial to understand how they affect each other. Sertraline is an antidepressant classified as a selective serotonin reuptake inhibitor (SSRI), while cimetidine is used to reduce stomach acid.

• Sertraline: It increases serotonin levels in the brain, improving mood and alleviating symptoms of depression.
• Cimetidine: It reduces acid production in the stomach, often used in treating ulcers and gastroesophageal reflux disease (GERD).

Understanding pharmacology allows healthcare providers to safely administer medications and anticipate possible side effects or interactions.

Drug Interactions

Drug interactions can occur when two or more medications are taken together, potentially altering the effectiveness and safety of each drug. These interactions can result in increased side effects, reduced efficacy, or unexpected health complications. In the context of sertraline and cimetidine, cimetidine may increase the serum levels of sertraline, leading to heightened side effects such as dizziness, nausea, and headache.
It's paramount to assess such potential interactions before any medication regime is established. Potential interactions between sertraline and naproxen—a non-steroidal anti-inflammatory drug (NSAID)—also need consideration. Combined, they can increase the risk of gastrointestinal bleeding.
Healthcare professionals play a vital role in managing and mitigating risks associated with drug interactions by:

• Monitoring patient responses: They must remain vigilant for any clinical signs of interaction.
• Educating patients: Patients should understand the potential for interactions and be encouraged to report unusual symptoms.
• Consulting resources: Utilizing tools like drug interaction checkers to identify possible risks.

Patient Safety

Patient safety involves practices that ensure the well-being of individuals receiving healthcare services. In pharmacology, this means administering medications safely and monitoring for adverse reactions or interactions. Reporting potential interactions, such as those between sertraline and cimetidine or naproxen, is a key consideration for maintaining patient safety.
Every step taken to safeguard a patient's health includes:

• Accurate medication administration: Ensuring the right dose is given at the right time.
• Monitoring for side effects: Observing patients for any adverse reactions or complications.
• Effective communication: Clearly discussing risks and safety measures with patients and caregivers.

These practices help to minimize medication errors and promote a culture of safety within the healthcare environment. Nurses are pivotal in facilitating patient education about their medications, enhancing overall patient comprehension and safety.

Nursing Assessment

Nursing assessment is the first step in the nursing process, where a nurse collects information to understand the patient's health status. It involves gathering both subjective and objective data, which helps in identifying potential health issues and establishing a baseline for care.
For patients with prescriptions like sertraline, nursing assessments focus on:

• Checking medication history: Knowing all current medications helps to identify any potential interactions.
• Assessing patient symptoms: Looking for signs of side effects such as mood changes or headaches.
• Evaluating patient understanding: Explaining the medication regimen and ensuring the patient can correctly follow it.

These assessments help ensure that the prescribed treatment is both safe and effective for the patient. Nurses use these evaluations to report back to physicians, highlighting any issues like interactions that need attention. Through comprehensive assessment, nurses are key to optimizing patient outcomes.