National Physical Therapy Examination (NPTE) Practice Exam

An elderly patient treated for depression is taking a tricyclic antidepressant. Which symptom should the physical therapist assistant monitor?

1. Dyspnea

2. Postural hypotension

3. Cardiac arrhythmias

4. Hyper-alertness

The correct answer is: Postural hypotension

Monitoring for postural hypotension is important when treating elderly patients who are on tricyclic antidepressants (TCAs). These medications can have anticholinergic effects and can interfere with normal cardiovascular regulation, leading to orthostatic hypotension. This condition occurs when a person experiences a significant drop in blood pressure upon standing up, which can result in dizziness, lightheadedness, and an increased risk of falls. Elderly patients are particularly susceptible to these adverse effects due to age-related changes in cardiovascular function. The potential for falls in this population is a significant concern, and as such, monitoring blood pressure, especially when transitioning to an upright position, becomes crucial in their care. While dyspnea, cardiac arrhythmias, and hyper-alertness can also occur with various medications or health conditions, they are not as directly linked or commonly monitored with the use of tricyclic antidepressants as postural hypotension is. Thus, vigilance in observing for postural changes is imperative in ensuring patient safety and well-being.