Question

A nurse is providing teaching to a client who has depression and a new prescription for fluoxetine (selective serotonin reuptake inhibitor). Which of the following statements by the client indicates an understanding of the teaching?

A. I should start to feel better within 24 hours of starting this medication.
B. I will be sure to follow a strict diet to avoid foods with tyramine.
C. I will continue to take St. John's Wort to increase the effects of the medication.
D. I should take acetaminophen instead of ibuprofen for my headaches while taking this medication.

Answer 1

The statement indicating an understanding of the teaching for fluoxetine is that the client should take acetaminophen instead of ibuprofen for headaches, revealing knowledge of the medication's interaction with NSAIDs and potential for increased bleeding risk.

Step-by-step explanation:

The statement that indicates an understanding of the teaching for a client who has depression and a new prescription for fluoxetine, a selective serotonin reuptake inhibitor (SSRI), is: "I should take acetaminophen instead of ibuprofen for my headaches while taking this medication." This is because SSRIs can increase the risk of bleeding, and ibuprofen, being a nonsteroidal anti-inflammatory drug (NSAID), also carries a risk of bleeding. Therefore, it is safer to use acetaminophen, which has a lower bleeding risk compared to NSAIDs.

It is important to note that SSRIs, including fluoxetine, often take several weeks to show clinical effectiveness for depression. Hence, the statement "I should start to feel better within 24 hours of starting this medication" is incorrect. Additionally, the restriction of foods containing tyramine applies to clients taking monoamine oxidase inhibitors (MAOIs), not SSRIs. The recommendation to avoid St. John's Wort is appropriate, as it may potentially interact with fluoxetine, leading to an increase in side effects or serotonin syndrome.