Question

Pls help!

David Mallory is a 28 yr old restaurant worker who presents to the clinic and states he is “going mad” with anxiety. He states he is feeling anxious almost every day; is constantly thinking about his job and future; and worried that he will get fired even though his manager assures him he is doing well. He also states that he simply feels “stuck” in his life. He states that he wakes up in the morning with a sense of “dread”, and finds it very difficult to get out of bed and start his day. He reports that he has consistent neck pain and often feels sore and tense in his back muscles. He also reports occasional stomach ache and nausea, especially in the morning before leaving his home. He states that occasionally he gets so anxious that he doesn't want to leave the house and “feels his heart racing” and becomes “terrified” about needing to talk with anyone. David presently takes no other medications except fexofenadine (Allegra) 180 mg daily during the Spring.

His vitals: T = 98.6 F (oral); BP = 132/82; apical pulse = 92 beats per minute, regular; and R = 18 breaths per minute.

The PCP begins David on sertraline (Zoloft), 50 mg daily, PO; and clonazepam (Klonopin) 0.5 mg PRN up to twice daily.

David states “I though Zoloft was only for depression? I'm not really feeling that depressed, why did the NP prescribe Zoloft?”

1. What information should the nurse provide in explaining the rationale for the client being prescribed sertraline (Zoloft)?

2. What patient education regarding adverse effects should the nurse provide regarding sertraline (Zoloft) and clonazepam (Klonopin).

3. lDavid also states to the nurse that he doesn’t “like the idea of always needing to use psych drugs” and wonders if there are additional things he can do to help decrease his anxiety. What additional options and strategies should the nurse discuss to help the patient mange his anxiety?

Answer 1

Ans1). Nurse should tell client that zoloft is given to him for his anxiety and panic disorder not for depression.

Also tells about spectrum of drug indications.

Ans2)

Nurse should tell patients about side effects like dizziness, Drowsiness, confusion, difficulty concentrating and give following education

Do not take alcohol

Avoid activities required mental concentration

Ans3)

Take deep breath

Exercise daily

Avoid alcohol and caffeine

Challenge your thoughts

Change the focus