The nurse is caring for a client who is six weeks pregnant and inquires about her prescribed antidepressant. Which statement, if made by the client, would indicate effective understanding?
The nurse is caring for a client who is six weeks pregnant and inquires about her prescribed antidepressant. Which statement, if made by the client, would indicate effective understanding?
A. "I will need to stop my antidepressant until after I have delivered."
[10%]
B. "I will not need an antidepressant while pregnant because pregnancy causes depression remission."
[4%]
C. "I may have to switch to a new antidepressant while I am pregnant."
[83%]
D. "If I continue my antidepressant medication, I must undergo a cesarean section at delivery."
[2%]
Statistics
Subject/Lesson
Subject
Maternal & Newborn Health
Lesson
Antepartum
Client Need
Test Plan
Health Promotion and Maintenance
Related Topic
Ante/Intra/Postpartum and Newborn Care
Item Type
Item Type
Analysis
Explanation
Choice C is correct. Depression and anxiety can still be effectively treated while a client is pregnant. SSRIs (citalopram, sertraline, fluoxetine) can be effectively continued while a client is pregnant to cause mood stabilization and prevent depressive episodes. The only SSRI likely to be switched is paroxetine because of its slight risk for teratogenicity. Thus, the client may have to be switched to a safer agent like sertraline if they take paroxetine. Even electroconvulsive therapy (ECT) is safe for a pregnant client.
Choice A is incorrect. Not treating antenatal depression and anxiety disorders may put the client at risk for destabilizing their mood, which at worse, could lead to self-harm. Thus, depression may be effectively managed with the vast majority of SSRIs. Pregnancy does not specifically put depression into remission.
Choice B is incorrect. Depression may worsen with pregnancy because of the fluctuating hormone levels.
Choice D is incorrect. SSRI usage does not trigger an automatic cesarean section at delivery.
Additional Info
✓ SSRIs are generally safe to continue during pregnancy, except for paroxetine.
✓ A client with unipolar depression and anxiety disorders should continue treatment as prescribed.
✓ If a client has ADHD, amphetamines are preferred over methylphenidate for their safety profile.
