Question

Question completion status: QUESTION 8 The PMHNP is assessing a 49-year-old male with a history of depression, post-traumatic stress disorder (PTSD) alcoholism with malnutrition, diabetes mellitus type 2, and hypertension. His physical assessment is unremarkable with the exception of peripheral edema bilaterally to his lower extremities and a chief complaint of pain with numbness and tingling to each leg 5/10. The PMHNP starts this patient on a low dose of doxepin (Sinequan). What is the next action that must be taken by the PMHNP? O A. Orders liver function tests O B. Educate the patient on avoiding grapefruits when taking this medication O C. Encourage this patient to keep fluids to 1500 ml/day until the swelling subsides. () D. Order a BUN/Creatinine test.

Answer 1

PMHNP is the Psychiatric Mental Health Nurse Practitioner

post Traumatic Stress Disorder is a type of disorder in which a person will not be able to recover after seeing or experiencing a terrifying event like accidents.

Depression is a disorder in which a person lose interest in doing the activities of daily living and will be continuously in a depressed mood.

Diabetes mellitus is the increased amount of glucose in the blood. Hypertension is the increase in blood pressure. When a person have diabetes mellitus and hypertension, they are more prone for cardiac and renal disorders. So it is important to monitor the Bun and creatinine levels.

Low dose Doxepin prescribed to the patient helps to reduce the depression. It has some side effects like urinary retension, dry mouth, blurred vision, confusion. Already the patient has some symptoms like peripheral edema. So it is important to monitor for the renal function.

a.

Liver Function Test is not very important at this time. So preference is not given to let.

b.

Grapefruits can be taken along with the medication. But patient have to avoid taking grape juice along with the drug Doxepin.

C.

Patient can be encouraged to be on fluid restriction only after confirming the function of the kidney so that the amount of fluid restrictions can be decided correctly.

d.

Investigations can be done to know about the renal function like Blood urea nitrogen and creatinine. This is important because the patient already have hypertension an diabetes mellitus and more prone for kidney damage.

Therefore option D is the correct answer.