A nurse is preparing to administer amitriptyline 150 mg PO at bedtime. The amount available is amitriptyline 75 mg tablet. How many tablets should the nurse administer per dose?

(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Choice A reason:

Creatinine: Creatinine is a waste product produced by muscles and is filtered out of the blood by the kidneys. Elevated creatinine levels can indicate kidney dysfunction. However, in this scenario, the primary concern is liver damage due to the combination of alcohol and acetaminophen, making AST a more relevant marker.

Choice B reason:

Aspartate aminotransferase (AST): AST is an enzyme found in the liver and heart. Elevated levels of AST can indicate liver damage. Given the client’s high intake of both alcohol and acetaminophen, there is a significant risk of liver damage. Monitoring AST levels can help assess the extent of liver injury.

Choice C reason:

Amylase: Amylase is an enzyme produced by the pancreas and salivary glands that helps in the digestion of carbohydrates. Elevated amylase levels are typically associated with pancreatic disorders, such as pancreatitis. While important, it is not the priority in this case where liver damage is the main concern.

Choice D reason:

Antidiuretic hormone (ADH): ADH is a hormone that helps regulate water balance in the body by controlling the amount of water reabsorbed by the kidneys. Abnormal levels of ADH can indicate issues with fluid balance, but it is not directly related to liver function or the effects of alcohol and acetaminophen.

Choice A reason: Relapse is an Indication that You Are Not Taking Your Medications Properly

This statement is not entirely accurate. While non-adherence to medication can be a factor in relapse, it is not the only cause. Schizophrenia is a complex condition, and relapses can occur even when medications are taken as prescribed. Stress, changes in routine, and other factors can also contribute to a relapse.

Choice B reason: You Should Keep Your Provider’s and Therapist’s Number with You

This statement indicates an understanding of the importance of having immediate access to professional help. Keeping contact information for healthcare providers and therapists readily available ensures that the client can quickly reach out for support if they notice early signs of relapse. This proactive approach can help manage symptoms before they escalate.

Choice C reason: Taking an Additional Dose of Medication is Appropriate as Soon as Signs of Relapse Appear

This statement is incorrect. Clients should not adjust their medication dosage without consulting their healthcare provider. Taking an additional dose can lead to adverse effects and may not address the underlying issue. It is crucial to follow the prescribed treatment plan and seek professional advice if symptoms worsen.

Choice D reason: You Should Be Aware that Excessive Sleeping is an Early Sign of Relapse

Excessive sleeping is not typically an early sign of schizophrenia relapse. Common early warning signs include insomnia, social withdrawal, difficulty concentrating, and increased paranoia. While changes in sleep patterns can be a symptom, it is more important to recognize the specific signs that have previously indicated a relapse for the individual.