The nurse realizes that some complementary and alternative therapies interact with selective serotonin reuptake inhibitors. Which complementary and alternative therapy interactions may cause serotonin syndrome? (Select all that apply.)

Correct Answer: C

Rationale: Rationale: St. John's wort can cause serotonin syndrome when combined with selective serotonin reuptake inhibitors due to its serotonin-enhancing effects. St. John's wort increases serotonin levels, leading to potentially dangerous levels when combined with SSRIs. Feverfew, Ma-huang, and Ginkgo biloba do not directly affect serotonin levels, making them unlikely to cause serotonin syndrome when combined with SSRIs.

Correct Answer: B

Rationale: The correct answer is B: Instruct the patient to avoid beer and cheddar cheese. Tranylcypromine sulfate is a monoamine oxidase inhibitor (MAOI), and consuming foods high in tyramine, such as beer and cheddar cheese, can lead to a hypertensive crisis due to the interaction with MAOIs. It is crucial for the nurse to advise the patient to avoid these foods to prevent serious complications. Incorrect choices: A: Warn the patient about severe hypotension - This is incorrect because MAOIs are known to cause hypertensive crises, not hypotension. C: Encourage the patient to take ginseng and ephedra - This is incorrect because ginseng and ephedra can interact with MAOIs and lead to an increased risk of hypertensive crisis. D: Encourage the patient to eat fruit such as bananas - This is incorrect because while a healthy diet is important, there is no specific indication for bananas

Correct Answer: D

Rationale: The correct answer is D because concurrent use of NSAIDs can increase lithium levels by reducing its renal clearance. This is due to NSAIDs inhibiting the renal excretion of lithium, leading to potential lithium toxicity. Option A is incorrect as the maximum dose of lithium is typically around 2.4 g/day. Option B is also incorrect as the therapeutic range for lithium is usually between 0.6 to 1.2 mEq/L for acute mania and 0.6 to 1.0 mEq/L for maintenance therapy. Option C is incorrect because lithium is known to inhibit the release of neurotransmitters, including gamma-aminobutyric acid, rather than increasing receptor sensitivity.

Correct Answer: A

Rationale: Correct Answer: A Rationale: 1. Antidepressants can initially worsen suicidal thoughts in some patients. 2. Monitoring for suicidal tendencies allows early intervention. 3. Suicide risk assessment is essential during antidepressant therapy. 4. Prompt identification of suicidal ideation can prevent self-harm. Summary: - B: Orthostatic hypotension is a common side effect but not directly related to monitoring antidepressant therapy. - C: Taking the drug with food is for gastrointestinal distress, not specific to antidepressant monitoring. - D: Information about drug effectiveness does not address the critical need to monitor for suicidal tendencies.

Correct Answer: A

Rationale: The correct answer is A: Observe the patient for motor tremors. Motor tremors are common side effects of lithium therapy, indicating toxicity. By observing for tremors, the nurse can detect early signs of lithium toxicity and take necessary actions. Monitoring for hypotension (choice B) and orthostatic hypotension (choice D) are not related to lithium therapy. Drawing lithium blood levels immediately after a dose (choice C) is not necessary as lithium levels are usually checked before the next dose.