A nurse is assisting in the care of a client who is taking chlorpromazine. Which of the following findings indicates a therapeutic effect medication?

A) Weight loss: Weight loss is not a sign of fluid overload; rather, it is more indicative of dehydration or insufficient nutritional intake. Fluid overload typically leads to weight gain due to the accumulation of excess fluid in the body, so weight loss would not be a manifestation of this condition.

B) Decreased skin turgor: Decreased skin turgor is a common sign of dehydration, not fluid overload. When a person is dehydrated, the skin loses its elasticity, and it takes longer to return to its normal position after being pinched. This is the opposite of what is seen in fluid overload, where excess fluid causes the skin to appear more swollen or taut.

C) Decreased blood pressure: Decreased blood pressure is more commonly associated with hypovolemia (low fluid volume) or dehydration, rather than fluid overload. In fluid overload, blood pressure may actually rise due to the increased volume of circulating blood, not decrease.

D) Crackles heard in the lungs: Crackles, or rales, heard in the lungs are a classic sign of fluid overload, particularly when the excess fluid accumulates in the lungs (pulmonary edema). This can occur due to the heart's inability to pump effectively, leading to fluid retention in the lungs. Therefore, crackles in the lungs are a key manifestation of fluid overload.

A) The child is unable to skate with good balance.
At 4 years old, a child’s balance and coordination are still developing. While skating requires more advanced skills, a child not having good balance at this age is not typically a concern unless other motor skills are delayed. Skating is not an expected milestone for a 4-year-old.

B) The child is unable to jump rope.
Jumping rope is a more complex skill that typically develops later, closer to ages 5 or 6, so the inability to do so at age 4 is not a cause for concern. It is a skill that requires fine motor coordination, balance, and timing, which may not be fully developed at this age.

C) The child is unable to walk downstairs on alternating feet.
At 4 years old, children are expected to be able to walk downstairs using alternating feet (one foot on each step). If a child cannot perform this task, it may indicate a delay in gross motor development, specifically in coordination and balance. This is a developmental milestone that typically emerges by age 4 and should be reported to the physical therapist for further evaluation.

D) The child is unable to walk backwards from heel to toe.
Walking backwards from heel to toe is a more advanced skill that typically develops later in childhood. This skill is not expected at age 4, so the child’s inability to do so is not a red flag for developmental concerns. It is more appropriate for older children.