A nurse is caring for a newborn who is receiving phototherapy treatment. Which of the following actions should the nurse take?

• HEENT – Dry mouth; Amitriptyline has strong anticholinergic effects, which inhibit salivary gland secretion, commonly resulting in dry mouth. This side effect can affect oral comfort, dental health, and appetite.
• Cardiovascular – Tachycardia: Tricyclic antidepressants like amitriptyline can cause tachycardia due to their anticholinergic properties and direct effects on cardiac conduction. These drugs inhibit vagal tone, which increases heart rate, and can also affect the sodium channels in cardiac tissue.
• Genitourinary – Urinary retention: Amitriptyline’s anticholinergic activity relaxes the detrusor muscle and contracts the internal urethral sphincter, impairing normal bladder emptying. This can lead to difficulty initiating urination and incomplete bladder emptying, particularly in older adults.
• Gastrointestinal – Constipation: By inhibiting parasympathetic activity in the GI tract, amitriptyline slows peristalsis, leading to constipation. This side effect is common and can become severe without dietary adjustments or the use of stool softeners.

A. "Why do you think your partner's symptoms are progressing so quickly?” This question can feel blaming and may cause the partner to become defensive, which is not therapeutic. This response shifts the burden of explanation to the partner and doesn't directly address their expressed feeling of being overwhelmed.
B. “You did the right thing by bringing your partner in for treatment.” While supportive, this statement shuts down further discussion and does not encourage the partner to express feelings or concerns.
C. “Can you talk about what was happening with your partner at home.” This open-ended question encourages the partner to share feelings and experiences, fostering communication and therapeutic rapport.
D. “You should make sure your partner takes the prescribed medication.” This response is prescriptive and shifts immediately to an action plan without first acknowledging or exploring the partner's current emotional state and the overwhelming situation they are describing. .