A client with schizophrenia receives a prescription for fluphenazine. Which instruction is most important for the nurse to include when teaching the client about this drug?

Wear sunscreen when going outside to prevent effects of sun sensitivity.

Notify your healthcare provider immediately if involuntary movements develop.

Drink water frequently throughout the day as the medication increases thirst.

Check blood pressure daily and notify the healthcare provider if it increases

Answer and Explanation

The Correct Answer is B

A) Wearing sunscreen when going outside to prevent effects of sun sensitivity is important for clients taking certain antipsychotic medications, but it is not the most critical instruction. While fluphenazine can cause photosensitivity, the risk of developing involuntary movements (extrapyramidal symptoms) is a more immediate concern that could significantly affect the client’s quality of life.

B) Notifying the healthcare provider immediately if involuntary movements develop is crucial when taking fluphenazine. This medication can lead to extrapyramidal symptoms such as tardive dyskinesia or acute dystonia, which require prompt assessment and intervention to prevent long-term complications. Educating the client about these potential side effects empowers them to seek timely help.

C) Drinking water frequently throughout the day is generally good advice for overall hydration, but fluphenazine does not significantly increase thirst. While maintaining hydration is important, the focus should be on the potential for serious side effects like involuntary movements, making this instruction secondary in priority.

D) Checking blood pressure daily and notifying the healthcare provider if it increases is relevant for some medications, particularly antihypertensives or those that can cause orthostatic hypotension. However, with fluphenazine, the more critical instruction revolves around recognizing and responding to neurological side effects rather than routine blood pressure monitoring, making this less of a priority.

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Correct Answer is C

Explanation

A) Aspirin 81 milligrams PO daily is commonly used as a low-dose antiplatelet medication and is generally not concerning in this context, especially with the symptoms described. It does not have a direct impact on blood pressure or the acute symptoms presented.

B) Losartan 50 mg PO daily is an antihypertensive medication used to manage high blood pressure. While the client’s blood pressure is elevated, this medication is appropriate for managing hypertension, and it does not pose an immediate concern.

C) Phenelzine 60 mg PO daily is of the most concern. It is a monoamine oxidase inhibitor (MAOI), which can have serious interactions with certain foods and medications, potentially leading to hypertensive crises, especially given the client’s high blood pressure of 216/108 mmHg. The client’s headache, nausea, and vomiting, combined with elevated vital signs, could indicate such a crisis, making this medication a significant concern.

D) Hydrochlorothiazide 12.5 mg PO daily is a thiazide diuretic commonly used to treat hypertension. While the client’s blood pressure is high, this medication is typically used to lower blood pressure and does not pose an immediate risk in this situation.

A. Recall methods that were most successful in the past. B. Turn to other activities to take one's mind off of the issues. C. Reach out to family and friends about feelings of abandonment. D. Relax and reduce the amount of effort to solve the problem.

Correct Answer is A

Explanation

A) Recalling methods that were most successful in the past is an effective coping strategy. This approach encourages the client to identify and utilize strategies that have previously helped them manage their depression. It fosters a sense of agency and can inspire motivation to engage in positive behaviors again.

B) Turning to other activities to take one's mind off of the issues may provide temporary relief, but it does not address the underlying issues related to depression. This strategy could lead to avoidance rather than active problem-solving and engagement with life.

C) Reaching out to family and friends about feelings of abandonment is important for social support; however, it may not be the first step in the coping strategy. The client may need to develop skills to articulate their feelings before reaching out, and it also doesn’t directly address their current disengagement from activities.

D) Relaxing and reducing the amount of effort to solve the problem may feel appealing but could reinforce avoidance behaviors. It’s crucial to encourage the client to engage actively with their emotions and challenges instead of stepping back entirely. The goal should be to empower the client to take small, manageable steps toward re-engagement with life, making option A the most suitable choice.

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A client with schizophrenia receives a prescription for fluphenazine. Which instruction is most important for the nurse to include when teaching the client about this drug?

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Correct Answer is C

Explanation

A client with depression is not attentive to personal hygiene, uses television watching as a means of escape from responsibilities, and describes an inability to enjoy the things that once gave them pleasure. Which coping strategy should the nurse include in the plan of care?

Correct Answer is A

Explanation

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